Healthcare Provider Details

I. General information

NPI: 1447973623
Provider Name (Legal Business Name): HOME NP SERVICES OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 112TH ST E
BRADENTON FL
34212-1631
US

IV. Provider business mailing address

313 112TH ST E
BRADENTON FL
34212-1631
US

V. Phone/Fax

Practice location:
  • Phone: 941-867-0470
  • Fax: 941-348-1007
Mailing address:
  • Phone: 941-867-0470
  • Fax: 941-348-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE VEGA
Title or Position: OWNER/AUTHORIZED SIGNER
Credential: APRN
Phone: 573-258-9833