MEDICARE: PROFESSIONAL CARE HOME HEALTH AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1124263652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL CARE HOME HEALTH AGENCY INC

Provider Business Mailing Address
First Line	:	1452 N KROME AVE
Second Line	:	SUITE 102E
City	:	FLORIDA CITY
State	:	FL
Zip	:	33034-2440
Country	:	US
Telephone Number	:	305-247-1270
Fax Number	:	305-247-1273

Provider Business Practice Location Address
First Line	:	1452 N KROME AVE
Second Line	:	SUITE 102E
City	:	FLORIDA CITY
State	:	FL
Zip	:	33034-2440
Country	:	US
Telephone Number	:	305-247-1270
Fax Number	:	305-247-1273

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NANCY B SOCARRAS
Credential	:
Telephone Number	:	305-247-1270

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	11/23/2010

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