Healthcare Provider Details

I. General information

NPI: 1063226736
Provider Name (Legal Business Name): IGNITE HOME HEALTH-REGION 7 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 S BLUFORD AVE
OCOEE FL
34761-2752
US

IV. Provider business mailing address

4030 HENDERSON BLVD STE 541
TAMPA FL
33629-4940
US

V. Phone/Fax

Practice location:
  • Phone: 800-298-5479
  • Fax:
Mailing address:
  • Phone: 727-409-5550
  • Fax:

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: PAUL T HAUSMAN
Title or Position: OWNER
Credential:
Phone: 727-409-5550