Healthcare Provider Details

I. General information

NPI: 1831008606
Provider Name (Legal Business Name): ROSIE PREMIUM HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6391 NE 118TH AVE
THE VILLAGES FL
32162-8615
US

IV. Provider business mailing address

6391 NE 118TH AVE
THE VILLAGES FL
32162-8615
US

V. Phone/Fax

Practice location:
  • Phone: 352-455-1317
  • Fax:
Mailing address:
  • Phone: 352-455-1317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ROSELINE AJAX
Title or Position: OWNER
Credential:
Phone: 352-455-1317