Provider Demographics
NPI:1073357620
Name:PHOENIX HOME HEALTH LLC
Entity type:Organization
Organization Name:PHOENIX HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CCFO
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ALINA
Authorized Official - Last Name:JUVIER SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-290-7171
Mailing Address - Street 1:8407 PINEHURST DR STE 115
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1532
Mailing Address - Country:US
Mailing Address - Phone:813-290-7171
Mailing Address - Fax:813-213-0911
Practice Address - Street 1:8407 PINEHURST DR STE 115
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1532
Practice Address - Country:US
Practice Address - Phone:813-290-7171
Practice Address - Fax:813-213-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health