Provider Demographics
NPI:1013291186
Name:BH-PTL, LLC
Entity type:Organization
Organization Name:BH-PTL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-542-7821
Mailing Address - Street 1:1750 W BROADWAY ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9618
Mailing Address - Country:US
Mailing Address - Phone:407-542-7821
Mailing Address - Fax:407-542-7823
Practice Address - Street 1:1750 W BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9618
Practice Address - Country:US
Practice Address - Phone:407-542-7821
Practice Address - Fax:407-542-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health