Healthcare Provider Details

I. General information

NPI: 1912825019
Provider Name (Legal Business Name): PAVILIS TRANPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 N US HIGHWAY 301 STE 200
TAMPA FL
33619-2271
US

IV. Provider business mailing address

3018 N US HIGHWAY 301 STE 200
TAMPA FL
33619-2271
US

V. Phone/Fax

Practice location:
  • Phone: 813-458-2859
  • Fax:
Mailing address:
  • Phone: 813-458-2859
  • 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: EDENA RAYMOND
Title or Position: MANAGER
Credential:
Phone: 813-458-2859