Healthcare Provider Details

I. General information

NPI: 1417313149
Provider Name (Legal Business Name): HERNANDO-PASCO HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 N 53RD ST
TEMPLE TERRACE FL
33617-4068
US

IV. Provider business mailing address

12470 TELECOM DR STE 301 ATTENTION: COMPLIANCE
TEMPLE TERRACE FL
33637-0904
US

V. Phone/Fax

Practice location:
  • Phone: 813-969-3700
  • Fax: 813-969-3717
Mailing address:
  • Phone: 813-871-8111
  • 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: CRYSTAL BUCCIARELLI
Title or Position: DIRECTOR OF LEGAL SERVICES
Credential: JD
Phone: 813-871-8075