=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710274329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEACEFUL SPIRIT HOME HEALTHCARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2011
-----------------------------------------------------
Last Update Date | 01/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6101 WEBB RD STE 109
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33615-2859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-960-5575
-----------------------------------------------------
Fax | 813-960-5576
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6101 WEBB RD STE 109
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33615-2859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-960-5575
-----------------------------------------------------
Fax | 813-960-5576
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LAURA DIAZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-960-5575
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------