Provider Demographics
NPI:1750667507
Name:CASTELLANOS HOME HEALTH CARE AGENCY, LLC.
Entity Type:Organization
Organization Name:CASTELLANOS HOME HEALTH CARE AGENCY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHALY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-879-1999
Mailing Address - Street 1:3430 W LAMBRIGHT ST
Mailing Address - Street 2:STE 103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4750
Mailing Address - Country:US
Mailing Address - Phone:813-879-1999
Mailing Address - Fax:813-879-0999
Practice Address - Street 1:3430 W LAMBRIGHT ST
Practice Address - Street 2:STE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4750
Practice Address - Country:US
Practice Address - Phone:813-879-1999
Practice Address - Fax:813-879-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherHOME HEALTH AGENCY