Healthcare Provider Details

I. General information

NPI: 1306456934
Provider Name (Legal Business Name): OPAL ROSE HOME CARE AND COMPANION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 1ST AVE N STE 111
ST PETERSBURG FL
33713-8422
US

IV. Provider business mailing address

PO BOX 41372
SAINT PETERSBURG FL
33743-1372
US

V. Phone/Fax

Practice location:
  • Phone: 727-350-5710
  • Fax: 727-357-5708
Mailing address:
  • Phone: 727-350-5710
  • Fax: 727-350-5708

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: LASHONNA DENISE MURPHY
Title or Position: CEO & ADMINISTRATOR
Credential: CNA
Phone: 727-350-5710