MEDICARE: PRESTIGE HOME HEALTHCARE OF TAMPA BAY, 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	:	1871257956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE HOME HEALTHCARE OF TAMPA BAY, LLC

Provider Business Mailing Address
First Line	:	13902 N DALE MABRY HWY STE 139
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2441
Country	:	US
Telephone Number	:	813-444-0320
Fax Number	:	813-200-2843

Provider Business Practice Location Address
First Line	:	13902 N DALE MABRY HWY STE 139
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2441
Country	:	US
Telephone Number	:	813-444-0320
Fax Number	:	813-200-2843

Authorized Official
Title or Position	:	OWNER
Name	:	DYONA VILLARIN
Credential	:	BSN, RN
Telephone Number	:	813-444-0320

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	03/16/2026

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