MEDICARE: ASPEN HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1437782943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	1647 SUN CITY CENTER PLZ BLDG 201B
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-5373
Country	:	US
Telephone Number	:	813-296-7339
Fax Number	:	813-441-8883

Provider Business Practice Location Address
First Line	:	1647 SUN CITY CENTER PLZ BLDG 201B
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-5373
Country	:	US
Telephone Number	:	813-331-5780
Fax Number	:	813-441-8883

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BERNARD O SPOONER
Credential	:	RN
Telephone Number	:	813-296-7339

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	07/21/2021

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Directions to “ASPEN HOME HEALTH LLC ” Practice Location

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