Healthcare Provider Details

I. General information

NPI: 1124699715
Provider Name (Legal Business Name): SIPP HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2354 WINTER WOODS BLVD STE 2336
WINTER PARK FL
32792-1944
US

IV. Provider business mailing address

2354 WINTER WOODS BLVD STE 2336
WINTER PARK FL
32792-1944
US

V. Phone/Fax

Practice location:
  • Phone: 407-792-4445
  • Fax:
Mailing address:
  • Phone: 407-792-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. AARON JOSHUA SIPP
Title or Position: CEO
Credential:
Phone: 689-710-1024