Healthcare Provider Details

I. General information

NPI: 1447821772
Provider Name (Legal Business Name): FRONTIDA HOME SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9507 GROVEDALE CIR UNIT 201
RIVERVIEW FL
33578-4184
US

IV. Provider business mailing address

9507 GROVEDALE CIR UNIT 201
RIVERVIEW FL
33578-4184
US

V. Phone/Fax

Practice location:
  • Phone: 813-464-9616
  • Fax:
Mailing address:
  • Phone: 813-464-9616
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS DENISE N HAWKINS
Title or Position: CEO
Credential:
Phone: 813-464-9616