Healthcare Provider Details

I. General information

NPI: 1558950311
Provider Name (Legal Business Name): VIP HOME CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 09/11/2025
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 W MAIN ST STE 202
TAMPA FL
33607-4322
US

IV. Provider business mailing address

1902 W MAIN ST STE 202
TAMPA FL
33607-4322
US

V. Phone/Fax

Practice location:
  • Phone: 813-833-4432
  • Fax:
Mailing address:
  • Phone: 813-833-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. TRENEECIA S GILMORE
Title or Position: OWNER
Credential: RN
Phone: 813-833-4332