1346463742 NPI number — HOME HEALTH CARE PROVIDERS OF SOUTH FLORIDA, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346463742 NPI number — HOME HEALTH CARE PROVIDERS OF SOUTH FLORIDA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH CARE PROVIDERS OF SOUTH FLORIDA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346463742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18044 NW 6 ST
Provider Second Line Business Mailing Address:
SUITE #104
Provider Business Mailing Address City Name:
PEMBROKE PINES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33029-2824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-438-6739
Provider Business Mailing Address Fax Number:
954-438-6740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18044 NW 6TH ST
Provider Second Line Business Practice Location Address:
SUITE #104
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33029-2824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-438-6739
Provider Business Practice Location Address Fax Number:
954-438-6740
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
TAMARA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
954-438-6739

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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