Provider Demographics
NPI:1164247300
Name:VITALITY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:VITALITY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-747-1938
Mailing Address - Street 1:801 W BAY DR STE 117
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3269
Mailing Address - Country:US
Mailing Address - Phone:786-747-1938
Mailing Address - Fax:727-279-4950
Practice Address - Street 1:801 W BAY DR STE 117
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3269
Practice Address - Country:US
Practice Address - Phone:786-747-1938
Practice Address - Fax:727-279-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health