Provider Demographics
NPI:1902871031
Name:PINNACLE HOME CARE, LLC
Entity type:Organization
Organization Name:PINNACLE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-814-6000
Mailing Address - Street 1:4023 TAMPA RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3212
Mailing Address - Country:US
Mailing Address - Phone:813-814-6000
Mailing Address - Fax:
Practice Address - Street 1:2505 SEVEN SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-3628
Practice Address - Country:US
Practice Address - Phone:813-814-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991792251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHHA299991792OtherSTATE LICENSE NUMBER
FL107797Medicare ID - Type UnspecifiedPROVIDER NUMBER