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General NPI Number Information
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NPI Number | 1619383015
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Entity Type | Organization
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Legal Business Name | ELINA COLON-PENA CARE MANGER SERVICES
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 6722 GRAND BAHAMA DR
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City | TAMPA
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State | FL
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Zip | 33615-5800
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Country | US
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Telephone | 813-846-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 MEMORIAL HWY STE 212D
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City | TAMPA
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State | FL
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Zip | 33615-5258
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Country | US
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Telephone | 813-846-5252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIANA COLON-PENA
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Credential |
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Telephone | 813-846-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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