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General NPI Number Information
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NPI Number | 1154340313
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Entity Type | Organization
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Legal Business Name | PRESTIGE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 SOUTHERN OAKS DR
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City | PLANT CITY
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State | FL
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Zip | 33563-1446
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Country | US
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Telephone | 813-759-8333
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Fax | 813-759-8337
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Provider Business Mailing Address
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Address Line | PO BOX 4736
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City | PLANT CITY
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State | FL
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Zip | 33563-0030
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Country | US
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Telephone | 813-759-8333
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Fax | 813-759-8337
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. KAY M TUCKER
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Credential | RN
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Telephone | 813-759-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | FL
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