Healthcare Provider Details

I. General information

NPI: 1508069055
Provider Name (Legal Business Name): SYLVAN HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 REGENCY OAKS BLVD SUITE S 105
CLEARWATER FL
33759-1524
US

IV. Provider business mailing address

2751 REGENCY OAKS BLVD SUITE S 105
CLEARWATER FL
33759-1524
US

V. Phone/Fax

Practice location:
  • Phone: 727-791-1500
  • Fax: 727-796-8495
Mailing address:
  • Phone: 727-791-1500
  • Fax: 727-796-8495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299991066
License Number StateFL

VIII. Authorized Official

Name: MS. JOHANNA HILL
Title or Position: DIRECTOR OF OPERATIONS
Credential: R.N.
Phone: 727-252-0541