Healthcare Provider Details

I. General information

NPI: 1801694864
Provider Name (Legal Business Name): ECENTREK HEALTH, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2732 GARDEN FALLS DR
BRANDON FL
33511-4712
US

IV. Provider business mailing address

2732 GARDEN FALLS DR
BRANDON FL
33511-4712
US

V. Phone/Fax

Practice location:
  • Phone: 813-557-3476
  • Fax: 813-501-1260
Mailing address:
  • Phone: 813-557-3476
  • Fax: 813-501-1260

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: MR. RODNEY RAYBURN SMITH II
Title or Position: CO-OWNER
Credential: PHLEBOTOMY TECH.
Phone: 813-557-3476