MEDICARE: LIVING WELL HOME HEALTH CARE 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	:	1164658514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING WELL HOME HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	9600 NW 25TH ST STE 5A
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33172-1416
Country	:	US
Telephone Number	:	305-599-8070
Fax Number	:	305-599-8090

Provider Business Practice Location Address
First Line	:	9600 NW 25TH ST STE 5A
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33172-1416
Country	:	US
Telephone Number	:	305-599-8070
Fax Number	:	305-599-8090

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARELIS FERNANDEZ
Credential	:
Telephone Number	:	305-599-8070

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	05/29/2009

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