Healthcare Provider Details

I. General information

NPI: 1609701267
Provider Name (Legal Business Name): PRIMELIFE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5526 HANSEL AVE STE 2
ORLANDO FL
32809-3405
US

IV. Provider business mailing address

5526 HANSEL AVE STE 2
ORLANDO FL
32809-3405
US

V. Phone/Fax

Practice location:
  • Phone: 407-988-3088
  • Fax: 407-988-3180
Mailing address:
  • Phone: 407-988-3088
  • Fax: 407-988-3180

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: KATILEIDY VAZQUEZ
Title or Position: OWNER
Credential:
Phone: 305-803-5255