MEDICARE: SENIOR SUPPORT SERVICING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1033732490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR SUPPORT SERVICING, LLC

Provider Business Mailing Address
First Line	:	5404 HOOVER BLVD STE 12
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5351
Country	:	US
Telephone Number	:	813-245-0058
Fax Number	:	813-692-1748

Provider Business Practice Location Address
First Line	:	5404 HOOVER BLVD STE 12
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5351
Country	:	US
Telephone Number	:	813-245-0058
Fax Number	:	800-576-1059

Authorized Official
Title or Position	:	ADON
Name	:	DR. PAULA I WOOD
Credential	:	PHD, RN
Telephone Number	:	863-381-1958

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	08/25/2023

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