Healthcare Provider Details

I. General information

NPI: 1518822717
Provider Name (Legal Business Name): PRESTIGE 786 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 SE BABB RD
BELLEVIEW FL
34420-4280
US

IV. Provider business mailing address

6333 SE BABB RD
BELLEVIEW FL
34420-4280
US

V. Phone/Fax

Practice location:
  • Phone: 903-618-0731
  • Fax:
Mailing address:
  • Phone: 903-618-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TALAL ZAHOOR
Title or Position: OWNER
Credential:
Phone: 903-618-0731