Healthcare Provider Details

I. General information

NPI: 1396601696
Provider Name (Legal Business Name): HOPEWELL SOUTHEAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 OAKFIELD DR
BRANDON FL
33511-2800
US

IV. Provider business mailing address

1405 NW 6TH ST STE 120
GAINESVILLE FL
32601-4021
US

V. Phone/Fax

Practice location:
  • Phone: 813-513-9097
  • Fax: 813-513-9334
Mailing address:
  • Phone: 352-240-1259
  • Fax: 352-519-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DAVID BULLOCK
Title or Position: MANAGER
Credential:
Phone: 352-362-4132