Healthcare Provider Details

I. General information

NPI: 1073246120
Provider Name (Legal Business Name): DYNAMIC HOME HEALTH CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 S COMBEE RD
LAKELAND FL
33801-6857
US

IV. Provider business mailing address

2133 S COMBEE RD
LAKELAND FL
33801-6857
US

V. Phone/Fax

Practice location:
  • Phone: 863-937-3658
  • Fax: 863-583-8374
Mailing address:
  • Phone: 863-937-3658
  • Fax: 863-583-8374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TARSHA SEAY TROUTMAN
Title or Position: CEO
Credential:
Phone: 863-669-5106