Healthcare Provider Details

I. General information

NPI: 1780617704
Provider Name (Legal Business Name): ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13925 17TH ST
DADE CITY FL
33525-4603
US

IV. Provider business mailing address

13925 17TH ST
DADE CITY FL
33525-4603
US

V. Phone/Fax

Practice location:
  • Phone: 813-779-6301
  • Fax: 813-779-6319
Mailing address:
  • Phone: 813-779-6301
  • Fax: 813-779-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA299992090
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MARK WHEELER
Title or Position: CFO
Credential:
Phone: 530-545-1409