Healthcare Provider Details

I. General information

NPI: 1356158646
Provider Name (Legal Business Name): S & S HOME CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S HOWARD AVE STE 103
TAMPA FL
33606-2473
US

IV. Provider business mailing address

701 S HOWARD AVE STE 103
TAMPA FL
33606-2473
US

V. Phone/Fax

Practice location:
  • Phone: 937-789-3446
  • Fax:
Mailing address:
  • Phone: 937-789-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MAZEN SHAQRA
Title or Position: PRESIDENT
Credential:
Phone: 937-789-3446