MEDICARE: SENSICARE OF SOUTH FLORIDA, 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	NR30211278	FL

General Provider Information

NPI Number	:	1467602094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENSICARE OF SOUTH FLORIDA, INC.

Provider Business Mailing Address
First Line	:	17027 W DIXIE HWY
Second Line	:	SUITE 105
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3734
Country	:	US
Telephone Number	:	305-947-9611
Fax Number	:	305-947-9644

Provider Business Practice Location Address
First Line	:	17027 W DIXIE HWY
Second Line	:	SUITE 105
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3734
Country	:	US
Telephone Number	:	305-947-9611
Fax Number	:	305-947-9644

Authorized Official
Title or Position	:	VICE PRESIDENT / ADMINISTRATOR
Name	:	MS. KIM SCHILLE
Credential	:
Telephone Number	:	305-947-9611

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	09/18/2008

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