Healthcare Provider Details

I. General information

NPI: 1689600082
Provider Name (Legal Business Name): PINNACLE HOME CARE OF PINELLAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 TAMPA RD STE 102
OLDSMAR FL
34677-3224
US

IV. Provider business mailing address

4023 TAMPA RD STE 2200
OLDSMAR FL
34677-3212
US

V. Phone/Fax

Practice location:
  • Phone: 813-814-6000
  • Fax:
Mailing address:
  • Phone: 813-814-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299992336
License Number StateFL

VIII. Authorized Official

Name: MR. MAX LAFER
Title or Position: PRESIDENT
Credential:
Phone: 813-814-6000