Healthcare Provider Details

I. General information

NPI: 1770118309
Provider Name (Legal Business Name): 6TH ST. BRIDGE MOBILITY AND HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 TECH BLVD STE 104
TAMPA FL
33619-7856
US

IV. Provider business mailing address

1205 TECH BLVD STE 104
TAMPA FL
33619-7856
US

V. Phone/Fax

Practice location:
  • Phone: 813-621-2001
  • Fax: 813-701-9681
Mailing address:
  • Phone: 813-787-8375
  • Fax: 813-714-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: RICHARD MCINTYRE
Title or Position: OWNER
Credential:
Phone: 813-223-0000