Provider Demographics
NPI:1265785554
Name:AEGIS HOME CARE LLC
Entity type:Organization
Organization Name:AEGIS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-439-2677
Mailing Address - Street 1:1694 BAYHILL DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1956
Mailing Address - Country:US
Mailing Address - Phone:727-439-2677
Mailing Address - Fax:727-787-5137
Practice Address - Street 1:1694 BAYHILL DR
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-1956
Practice Address - Country:US
Practice Address - Phone:727-439-2677
Practice Address - Fax:727-787-5137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health