MEDICARE: GOOD FRIENDS SERVICES, 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		FL

General Provider Information

NPI Number	:	1134238306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD FRIENDS SERVICES, INC.

Provider Business Mailing Address
First Line	:	9500 NW 77TH AVE
Second Line	:	SUITE 28
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-2530
Country	:	US
Telephone Number	:	786-522-2346
Fax Number	:	786-522-2347

Provider Business Practice Location Address
First Line	:	9500 NW 77TH AVE
Second Line	:	SUITE 28
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-2530
Country	:	US
Telephone Number	:	786-522-2346
Fax Number	:	786-522-2347

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. IGNACIO CAO
Credential	:
Telephone Number	:	786-522-2346

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/22/2020

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