=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588990212
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSURANCE HOME HEALTH CARE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2009
-----------------------------------------------------
Last Update Date | 10/21/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 N PARSONS AVE STE 106A SUITE 102
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33510-4538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-443-2145
-----------------------------------------------------
Fax | 813-448-3799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 N PARSONS AVE STE 106A SUITE 102
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33510-4538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-443-2145
-----------------------------------------------------
Fax | 813-448-3799
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. YENISEY MAZOLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-516-1278
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------