Provider Demographics
NPI:1790977627
Name:AFFINITY HEALTH SERVICES
Entity Type:Organization
Organization Name:AFFINITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:813-873-1472
Mailing Address - Street 1:PO BOX 151364
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-1364
Mailing Address - Country:US
Mailing Address - Phone:813-873-1472
Mailing Address - Fax:813-936-0800
Practice Address - Street 1:8405 N HIMES AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-8356
Practice Address - Country:US
Practice Address - Phone:813-873-1472
Practice Address - Fax:813-936-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR30211280251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL687394400Medicaid