Healthcare Provider Details

I. General information

NPI: 1013513852
Provider Name (Legal Business Name): SDM UNIVERSAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9021 INDIGO BREEZE CT
TAMPA FL
33637-5304
US

IV. Provider business mailing address

9021 INDIGO BREEZE CT
TAMPA FL
33637-5304
US

V. Phone/Fax

Practice location:
  • Phone: 786-972-5032
  • Fax: 813-252-9605
Mailing address:
  • Phone: 786-972-5032
  • Fax: 813-252-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHEILA M DE JESUS
Title or Position: DIRECTOR
Credential:
Phone: 786-972-5032