Healthcare Provider Details

I. General information

NPI: 1902921455
Provider Name (Legal Business Name): ETAIROS HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 W. MCNAB ROAD SUITE 203
TAMARAC FL
33321
US

IV. Provider business mailing address

13787 BELCHER RD S STE 220
LARGO FL
33771
US

V. Phone/Fax

Practice location:
  • Phone: 954-714-3333
  • Fax: 954-485-6101
Mailing address:
  • Phone: 727-723-7532
  • Fax: 727-797-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299990986
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRETT RAGER
Title or Position: VP REIMBURSEMENT
Credential:
Phone: 727-614-8300