MEDICARE: ASSURA HOME HEALTH CARE 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	:	1992590111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURA HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	776 W LUMSDEN RD STE 6
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8805
Country	:	US
Telephone Number	:	813-574-9736
Fax Number	:

Provider Business Practice Location Address
First Line	:	776 W LUMSDEN RD STE 6
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8805
Country	:	US
Telephone Number	:	813-574-9736
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANE NGANKO SANDJONG
Credential	:
Telephone Number	:	813-574-9736

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	04/09/2025

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