Healthcare Provider Details

I. General information

NPI: 1962870659
Provider Name (Legal Business Name): ADVANTAGE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11141 COUNTY LINE RD SUITE #114
SPRING HILL FL
34609-5620
US

IV. Provider business mailing address

11141 COUNTY LINE RD SUITE #114
SPRING HILL FL
34609-5620
US

V. Phone/Fax

Practice location:
  • Phone: 352-606-2648
  • Fax:
Mailing address:
  • Phone: 352-606-2648
  • 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. THOMAS WINGO
Title or Position: PRESIDENT
Credential:
Phone: 813-496-9619