Healthcare Provider Details

I. General information

NPI: 1285832923
Provider Name (Legal Business Name): VANTAGE HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 KASS CIR
SPRING HILL FL
34606-4308
US

IV. Provider business mailing address

1275 KASS CIR
SPRING HILL FL
34606-4308
US

V. Phone/Fax

Practice location:
  • Phone: 352-238-1048
  • Fax:
Mailing address:
  • Phone: 352-238-1048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. VICTOR ENRIQUEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-238-1048