MEDICARE: JULIE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1588418222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	3435 SW 108TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3517
Country	:	US
Telephone Number	:	786-963-6040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 SW 108TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3517
Country	:	US
Telephone Number	:	786-963-6040
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISABEL C OBREGON
Credential	:
Telephone Number	:	786-277-4481

Provider Enumeration Date	:	04/17/2024
Last Update Date	:	04/17/2024

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