MEDICARE: PRIMELIFE HOME HEALTH SERVICES 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	:	1609701267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMELIFE HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	5526 HANSEL AVE STE 2
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-3405
Country	:	US
Telephone Number	:	407-988-3088
Fax Number	:	407-988-3180

Provider Business Practice Location Address
First Line	:	5526 HANSEL AVE STE 2
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-3405
Country	:	US
Telephone Number	:	407-988-3088
Fax Number	:	407-988-3180

Authorized Official
Title or Position	:	OWNER
Name	:	KATILEIDY VAZQUEZ
Credential	:
Telephone Number	:	305-803-5255

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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