Healthcare Provider Details

I. General information

NPI: 1922864347
Provider Name (Legal Business Name): OHI WEST MEDICAL GROUP II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 TOWN CENTER BLVD STE D
BRANDON FL
33511-2906
US

IV. Provider business mailing address

38135 MARKET SQUARE DR
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-979-0440
  • Fax:
Mailing address:
  • Phone: 813-979-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOE DELATORRE
Title or Position: CEO
Credential:
Phone: 813-780-8440