Healthcare Provider Details

I. General information

NPI: 1497110720
Provider Name (Legal Business Name): SUNNY HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8875 HIDDEN RIVER PKWY SUITE 300
TAMPA FL
33637-1035
US

IV. Provider business mailing address

104 WHITAKER RD
LUTZ FL
33549-5642
US

V. Phone/Fax

Practice location:
  • Phone: 813-367-2057
  • Fax: 813-971-0180
Mailing address:
  • Phone: 352-275-1164
  • Fax: 352-341-1689

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NORMA CABRERA
Title or Position: PRESIDENT
Credential:
Phone: 352-275-1164