Healthcare Provider Details
I. General information
NPI: 1477417129
Provider Name (Legal Business Name): TRESSAHOLIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11970 N FLORIDA AVE
TAMPA FL
33612-5222
US
IV. Provider business mailing address
11970 N FLORIDA AVE
TAMPA FL
33612-5222
US
V. Phone/Fax
- Phone: 813-390-8497
- Fax:
- Phone: 813-390-8497
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TEQUILA
FLETCHER
Title or Position: OWNER
Credential:
Phone: 813-390-8497