Healthcare Provider Details

I. General information

NPI: 1902187693
Provider Name (Legal Business Name): SHUAYB HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11026 NORTHCLIFFE BLVD STE 1
SPRING HILL FL
34608-3768
US

IV. Provider business mailing address

11026 NORTHCLIFFE BLVD
SPRING HILL FL
34608-3768
US

V. Phone/Fax

Practice location:
  • Phone: 352-942-3813
  • Fax:
Mailing address:
  • Phone: 352-515-6932
  • Fax: 352-515-6932

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: MAYSSAN SHUAYB
Title or Position: PRES
Credential:
Phone: 352-942-3813