MEDICARE: ABRAZOS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1538925409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABRAZOS HOME CARE LLC

Provider Business Mailing Address
First Line	:	1995 E OAKLAND PARK BLVD STE 210
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33306-1137
Country	:	US
Telephone Number	:	954-999-0281
Fax Number	:	954-999-0543

Provider Business Practice Location Address
First Line	:	1995 E OAKLAND PARK BLVD STE 210
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33306-1137
Country	:	US
Telephone Number	:	954-999-0281
Fax Number	:	954-999-0543

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ERIC RATCHELL
Credential	:
Telephone Number	:	305-302-7270

Provider Enumeration Date	:	02/27/2024
Last Update Date	:	08/26/2024

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