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General NPI Number Information
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NPI Number | 1629448725
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA PROFESSIONALS INC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 202 ALLAMANDA DR
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City | LAKELAND
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State | FL
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Zip | 33803-2928
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Country | US
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Telephone | 863-333-0650
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Fax | 863-583-0421
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Provider Business Mailing Address
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Address Line | 202 ALLAMANDA DR
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City | LAKELAND
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State | FL
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Zip | 33803-2928
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Country | US
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Telephone | 863-333-0650
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Fax | 863-583-0421
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Authorized Official
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Title or Position | OWNER
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Name | ODALMIS BARROSO
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Credential |
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Telephone | 786-873-8117
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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 |
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