MEDICARE: MOUNT AUBURN, 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	HHA219830961	FL

General Provider Information

NPI Number	:	1437131059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT AUBURN, INC.

Provider Business Mailing Address
First Line	:	5790 NW 72ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33166-4210
Country	:	US
Telephone Number	:	305-917-0363
Fax Number	:	305-917-0368

Provider Business Practice Location Address
First Line	:	5790 NW 72ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33166-4210
Country	:	US
Telephone Number	:	305-917-0363
Fax Number	:	305-917-0368

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. MARIA MARQUEZ
Credential	:
Telephone Number	:	305-917-0363

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	12/10/2012

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