Healthcare Provider Details

I. General information

NPI: 1528246980
Provider Name (Legal Business Name): ETAIROS HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13787 BELCHER RD S SUITE 220
LARGO FL
33771
US

IV. Provider business mailing address

13787 BELCHER RD S SUITE 220
LARGO FL
33771-4065
US

V. Phone/Fax

Practice location:
  • Phone: 727-723-7532
  • Fax: 727-797-4733
Mailing address:
  • Phone: 727-723-7532
  • Fax: 727-797-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHHA 299992542
License Number StateFL

VIII. Authorized Official

Name: MR. BRETT RAGER
Title or Position: VP BILLING & REIMBURSEMENT
Credential:
Phone: 727-723-7532