Healthcare Provider Details

I. General information

NPI: 1295320190
Provider Name (Legal Business Name): MASTER HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 CONROY WINDERMERE ROAD SUITE 200, PMB 212
WINDERMERE FL
34786
US

IV. Provider business mailing address

9100 CONROY WINDERMERE ROAD SUITE 200, PMB 212
WINDERMERE FL
34786
US

V. Phone/Fax

Practice location:
  • Phone: 352-678-8582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: GINA ESTUPINAN
Title or Position: MANAGER/OWNER
Credential:
Phone: 352-678-8582