Healthcare Provider Details

I. General information

NPI: 1821433376
Provider Name (Legal Business Name): MEDICOR HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33853 STATE ROAD 54 SUITE 101
ZEPHYRHILLS FL
33543-9175
US

IV. Provider business mailing address

33853 STATE ROAD 54 SUITE 101
ZEPHYRHILLS FL
33543-9175
US

V. Phone/Fax

Practice location:
  • Phone: 813-930-8000
  • Fax: 813-930-8026
Mailing address:
  • Phone: 813-930-8000
  • Fax: 813-930-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MANUEL DELGADO JR.
Title or Position: PRESIDENT
Credential:
Phone: 813-930-8000