Provider Demographics
NPI:1356715031
Name:QUALITY HOME CARE OF TAMPA BAY LLC
Entity type:Organization
Organization Name:QUALITY HOME CARE OF TAMPA BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-336-4477
Mailing Address - Street 1:120 STATE ST E STE 105
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3647
Mailing Address - Country:US
Mailing Address - Phone:813-336-4477
Mailing Address - Fax:
Practice Address - Street 1:120 STATE ST E STE 105
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3647
Practice Address - Country:US
Practice Address - Phone:813-336-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health