Provider Demographics
NPI:1184066094
Name:WEST FLORIDA PPHOMEHEALTH, LLC
Entity type:Organization
Organization Name:WEST FLORIDA PPHOMEHEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER-VIKKELSOE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:352-291-6611
Mailing Address - Street 1:1701 NE 42ND AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-8024
Mailing Address - Country:US
Mailing Address - Phone:727-343-1433
Mailing Address - Fax:727-343-2472
Practice Address - Street 1:10508 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4136
Practice Address - Country:US
Practice Address - Phone:813-872-8566
Practice Address - Fax:813-872-8564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000089100Medicaid
107120Medicare Oscar/Certification