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Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BONNIE L CRAWFORD (DIRECTOR)
(813) 931-8335
Entity
Organization

Contact information

Practice address
10549 N FLORIDA AVE, SUITE H, TAMPA, FL 33612-6707
(813) 931-8335
(813) 931-8677
Mailing address
10549 N FLORIDA AVE, SUITE H, TAMPA, FL 33612-6707
(813) 931-8335
(813) 931-8677

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
30211132
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
685454196
FL
Enumeration date
01/02/2007
Last updated
06/16/2008
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