NPIMap

Organization Active NPI

Advanced Home Health of Tampa, Inc.

  • Home Health Agency
  • Tampa, FL
National Provider Identifier
1336475607
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ADVANCED HOME HEALTH OF TAMPA, INC.
Practice address
3903 Northdale Blvd
Suite 100 W
Tampa, FL 33624-1864
Phone
(813) 237-3456
Fax
(813) 237-4567
NPI assigned
Oct 21, 2009
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Mr. Antonio Del Valle
Title
Administrator
Phone
(813) 237-3456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3903 Northdale Blvd
Suite 100 W
Tampa, FL 33624-1864

Mailing address

3903 Northdale Blvd
Suite 100 W
Tampa, FL 33624-1864
Phone (813) 237-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100322000137 FL Part A Provider - Home Health Agency 8224163878 Practice locations: Tampa, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336475607. Details of each certification follow.

Home health agency certification: CCN 109656

Legal name
ADVANCED HOME HEALTH OF TAMPA, INC.
Doing business as
ADVANCED HOME HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 5, 2011
Last certification
Sep 19, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 18, 2009 in FL
Enrollment address
3903 Northdale Blvd
Ste 100-W
Tampa, FL 33624
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advanced Home Health of Tampa IncCCN 109656 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jan 5, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2003308Advanced Home Health of Tampa Inc3903 Northdale Blvd Ste 100-W, Tampa, FL 33624Certificate of waiverFeb 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Advanced Home Health of Tampa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

205 W Dr Martin Luther King Jr Blvd
Ste 204
Tampa, FL 33603
Phone (813) 237-3456

3903 Northdale Blvd
Ste 100
Tampa, FL 33624

3903 Northdale Blvd
Ste 100W
Tampa, FL 33624
Phone (813) 341-7227

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Antonio del Valle Individual 5% Or Greater Indirect Ownership Interest Oct 16, 2020 49.5%
Corporate OfficerPresident Oct 16, 2020 49.5%
Corporate DirectorPresident Oct 16, 2020 49.5%
W-2 Managing EmployeePresident Oct 16, 2020 100%
Mario H Paez Lanchero Individual 5% Or Greater Indirect Ownership Interest Jan 12, 2022 50.5%
Corporate OfficerVice President Nov 13, 2014 5.5%
W-2 Managing Employee Nov 13, 2014 50.5%
Good Deed Investors LLC Organization, Tampa, FL Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Oct 16, 2020 49.5%
South Kings Ave L.L.C. Organization, Tampa, FL LLC 5% Or Greater Direct Ownership Interest Jan 12, 2022 50.5%
Ruth Janna Individual 5% Or Greater Indirect Ownership Interest Oct 16, 2020 49.5%

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1336475607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD",
            "address_2": "SUITE 100 W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241864",
            "telephone_number": "813-237-3456",
            "fax_number": "813-237-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD",
            "address_2": "SUITE 100 W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241864",
            "telephone_number": "813-237-3456",
            "fax_number": "813-237-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HOME HEALTH OF TAMPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-21",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "DEL VALLE",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-237-3456",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.