1780617704 NPI number — ADVENTHEALTH HOME HEALTH AND HOSPICE INC

Table of content: MR. VICENTE NEVARDO LOZADA MISION M.D. (NPI 1013937614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780617704 NPI number — ADVENTHEALTH HOME HEALTH AND HOSPICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780617704
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13925 17TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DADE CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33525-4603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-779-6301
Provider Business Mailing Address Fax Number:
813-779-6319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13925 17TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DADE CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33525-4603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-779-6301
Provider Business Practice Location Address Fax Number:
813-779-6319
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHEELER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
530-545-1409

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HHA299992090 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 108170 . This is a "UNITED HEALTH MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108170 . This is a "WELLCARE MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 533 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108170 . This is a "UNIVERSAL HEALTHCARE MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108170 . This is a "KEYSTONE HP WEST MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108170 . This is a "HUMANA GOLD PLUS HMO MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108170 . This is a "HUMANA GOLD CHC MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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