Active NPI
Excellence in Home Health Services LLC
- Home Health Agency
- Land O Lakes, FL
National Provider Identifier
1407496904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- EXCELLENCE IN HOME HEALTH SERVICES LLC
- Practice address
- 3134 Whitehead LN
Land O Lakes, FL 34638-7200 - Phone
- (813) 417-1128
- Fax
- (866) 470-3118
- NPI assigned
- Jan 13, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vincentp P Deluca
- Title
- Consultant
- Phone
- (941) 323-3717
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
3134 Whitehead LN
Land O Lakes, FL 34638-7200
Mailing address
3134 Whitehead LN
Land O Lakes, FL 34638-7200
Phone (813) 417-1128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200730003819 | FL | Part A Provider - Home Health Agency | 5395160816 | Practice locations: Tampa, FL |
Home health agency certification: CCN 687157
- Legal name
- EXCELLENCE IN HOME HEALTH SERVICES LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 22, 2021
- Last certification
- Dec 22, 2021
- Organization structure
- LLC
- Incorporated
- Dec 12, 2019 in FL
- Enrollment address
- 2701 W Busch Blvd
Ste 155
Tampa, FL 33618-4512
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Excellence in Home Health Services LLC
- Overall star rating
- Ownership
- -
- Certified
- Dec 22, 2021
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2189501 | Excellence in Home Health Services LLC | Certificate of waiver | Jul 30, 2026 |
National Provider Directory
National Provider DirectoryLocations
2701 W Busch Blvd
Ste 155
Tampa, FL 33618
Phone (813) 649-8102
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Ivonne a Encarnacion | 5% Or Greater Direct Ownership Interest | Dec 12, 2019 | 50% |
| Corporate Director | Dec 12, 2019 | 50% | |
| W-2 Managing Employee | Dec 12, 2019 | ||
| Ana Rivero-Pons | 5% Or Greater Direct Ownership Interest | Dec 12, 2019 | 50% |
| Corporate Director | Dec 12, 2019 | 50% | |
| W-2 Managing Employee | Dec 12, 2019 |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- General Practice Physician
- Tampa, FL
- NPI 1578828869
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578873600000",
"number": "1407496904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3134 WHITEHEAD LN",
"city": "LAND O LAKES",
"state": "FL",
"postal_code": "346387200",
"telephone_number": "813-417-1128",
"fax_number": "866-470-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3134 WHITEHEAD LN",
"city": "LAND O LAKES",
"state": "FL",
"postal_code": "346387200",
"telephone_number": "813-417-1128",
"fax_number": "866-470-3118"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCELLENCE IN HOME HEALTH SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-13",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A",
"authorized_official_last_name": "DELUCA",
"authorized_official_first_name": "VINCENTP",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "CONSULTANT",
"authorized_official_telephone_number": "941-323-3717"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Land O Lakes, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.