Organization Active NPI

Pinellas Professional Home Care,Inc.

  • In Home Supportive Care Agency
  • Clearwater, FL
National Provider Identifier
1053619320
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PINELLAS PROFESSIONAL HOME CARE,INC.
Practice address
2075 Dunston Cove Rd
Clearwater, FL 33755-1316
Phone
(727) 418-4198
Fax
(727) 467-0923
NPI assigned
Mar 10, 2011
Last updated
Mar 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Amir Malak
Title
President
Phone
(727) 418-4198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2075 Dunston Cove Rd
Clearwater, FL 33755-1316

Mailing address

2075 Dunston Cove Rd
Clearwater, FL 33755-1316
Phone (727) 418-4198

Other identifiers 1

IdentifierTypeStateIssuer
691579596MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1053619320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 DUNSTON COVE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551316",
            "telephone_number": "727-418-4198",
            "fax_number": "727-467-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 DUNSTON COVE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551316",
            "telephone_number": "727-418-4198",
            "fax_number": "727-467-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELLAS PROFESSIONAL HOME CARE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "MALAK",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-418-4198",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691579596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.