Individual provider Active NPI

Michael Hatzidakis

  • Home Health Aide
  • Largo, FL
National Provider Identifier
1174970743
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
30211705 Issued in FL
Practice address
10225 Ulmerton Rd
Build 10B
Largo, FL 33771-3538
Phone
(727) 754-9787
Fax
(727) 754-9788
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 30211705 FL Primary

Addresses

Primary practice location

10225 Ulmerton Rd
Build 10B
Largo, FL 33771-3538

Mailing address

PO Box 635
Largo, FL 33779-0635
Phone (727) 754-9787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30211705FLMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1174970743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337790635",
            "telephone_number": "727-754-9787",
            "fax_number": "727-754-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 ULMERTON RD",
            "address_2": "BUILD 10B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337713538",
            "telephone_number": "727-754-9787",
            "fax_number": "727-754-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZIDAKIS",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "30211705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.