Provider Demographics
NPI:1871257956
Name:PRESTIGE HOME HEALTHCARE OF TAMPA BAY LLC
Entity Type:Organization
Organization Name:PRESTIGE HOME HEALTHCARE OF TAMPA BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UNYIME
Authorized Official - Middle Name:
Authorized Official - Last Name:USORO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-482-8241
Mailing Address - Street 1:2701 W BUSCH BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4579
Mailing Address - Country:US
Mailing Address - Phone:813-482-8241
Mailing Address - Fax:
Practice Address - Street 1:2701 W BUSCH BLVD STE 214
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4579
Practice Address - Country:US
Practice Address - Phone:813-482-8241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health