MEDICARE: FAMILY HOME CARE LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1447674411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HOME CARE LLC

Provider Business Mailing Address
First Line	:	7900 NW 33RD ST
Second Line	:	SUITE 106
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2209
Country	:	US
Telephone Number	:	305-702-9441
Fax Number	:	305-702-9442

Provider Business Practice Location Address
First Line	:	7900 NW 33RD ST
Second Line	:	SUITE 106
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2209
Country	:	US
Telephone Number	:	305-702-9441
Fax Number	:	305-702-9442

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHANA URBINA
Credential	:
Telephone Number	:	305-702-9441

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/12/2014

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Directions to “FAMILY HOME CARE LLC ” Practice Location

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