Healthcare Provider Details

I. General information

NPI: 1134487697
Provider Name (Legal Business Name): SUMILANG HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 04/28/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 NE COACHMAN RD STE B
CLEARWATER FL
33765-2610
US

IV. Provider business mailing address

2040 NE COACHMAN RD STE B
CLEARWATER FL
33765-2610
US

V. Phone/Fax

Practice location:
  • Phone: 727-345-3600
  • Fax: 727-245-8567
Mailing address:
  • Phone: 727-345-3600
  • Fax: 727-245-8567

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: ROBERT DANIEL SPARKS
Title or Position: OWNER
Credential: RN
Phone: 727-641-1116