MEDICARE: M D M HOME HEALTH CORPORATION

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	:	1245403732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M D M HOME HEALTH CORPORATION

Provider Business Mailing Address
First Line	:	17358 S DIXIE HWY
Second Line	:
City	:	PERRINE
State	:	FL
Zip	:	33157-4319
Country	:	US
Telephone Number	:	305-253-2763
Fax Number	:	305-253-2767

Provider Business Practice Location Address
First Line	:	17358 S DIXIE HWY
Second Line	:
City	:	PERRINE
State	:	FL
Zip	:	33157-4319
Country	:	US
Telephone Number	:	305-253-2763
Fax Number	:	305-253-2767

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARIA MESA
Credential	:
Telephone Number	:	305-253-2763

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	04/07/2008

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Directions to “M D M HOME HEALTH CORPORATION ” Practice Location

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