Healthcare Provider Details

I. General information

NPI: 1194653337
Provider Name (Legal Business Name): VANCORP HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3812 W LINEBAUGH AVE STE 108
TAMPA FL
33618-8702
US

IV. Provider business mailing address

7862 W IRLO BRONSON MEMORIAL HWY UNIT 470
KISSIMMEE FL
34747-1738
US

V. Phone/Fax

Practice location:
  • Phone: 813-776-6099
  • Fax:
Mailing address:
  • Phone: 813-776-6099
  • Fax:

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: MR. MICHAEL VAN DEGNA
Title or Position: VICE PRESIDENT
Credential:
Phone: 813-776-6099