MEDICARE: LIBERTY HOME CARE, 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	HHA20645096	FL

General Provider Information

NPI Number	:	1568413789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY HOME CARE, INC.

Provider Business Mailing Address
First Line	:	1840 W 49TH ST
Second Line	:	SUITE #509
City	:	HIALEAH
State	:	FL
Zip	:	33012-2942
Country	:	US
Telephone Number	:	305-823-7350
Fax Number	:	305-823-7409

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST
Second Line	:	SUITE #509
City	:	HIALEAH
State	:	FL
Zip	:	33012-2942
Country	:	US
Telephone Number	:	305-823-7350
Fax Number	:	305-823-7409

Authorized Official
Title or Position	:	VICE PRESIDENT / ADMINISTRATOR
Name	:	MRS. ALICIA SANCHEZ
Credential	:
Telephone Number	:	305-823-7350

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	08/22/2020

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Directions to “LIBERTY HOME CARE, INC. ” Practice Location

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