Healthcare Provider Details

I. General information

NPI: 1841048493
Provider Name (Legal Business Name): RESILIENT SOUL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 VILLENA AVE
TAMPA FL
33612-5017
US

IV. Provider business mailing address

7620 MASSACHUSETTS AVE STE 2
NEW PORT RICHEY FL
34653-3022
US

V. Phone/Fax

Practice location:
  • Phone: 727-203-2418
  • Fax:
Mailing address:
  • Phone: 727-203-2418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA LOZADA
Title or Position: OWNER
Credential:
Phone: 727-203-2418