Provider Demographics
NPI:1750335170
Name:SUPERIOR HOME HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:SUPERIOR HOME HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOOK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-572-1514
Mailing Address - Street 1:2860 SCHERER DR N
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1023
Mailing Address - Country:US
Mailing Address - Phone:727-572-1514
Mailing Address - Fax:727-572-1560
Practice Address - Street 1:7331 OFFICE PARK PL
Practice Address - Street 2:SUITE 200
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8239
Practice Address - Country:US
Practice Address - Phone:321-259-3733
Practice Address - Fax:321-259-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991835251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108218Medicare ID - Type UnspecifiedHOME HEALTH AGENCY