Provider Demographics
NPI:1205957479
Name:HERNANDO HEALTH CARE, INC
Entity type:Organization
Organization Name:HERNANDO HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-546-9692
Mailing Address - Street 1:7235 BRYAN DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1538
Mailing Address - Country:US
Mailing Address - Phone:727-546-9692
Mailing Address - Fax:727-547-0942
Practice Address - Street 1:307 HOWELL AVE
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2039
Practice Address - Country:US
Practice Address - Phone:352-796-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7622310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility