MEDICARE: MIHOM HEALTHCARE 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	299991919	FL

General Provider Information

NPI Number	:	1730235276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIHOM HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	2100 SE HILLMOOR DR
Second Line	:	SUITE102
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-8057
Country	:	US
Telephone Number	:	772-873-3838
Fax Number	:	772-873-3839

Provider Business Practice Location Address
First Line	:	2100 SE HILLMOOR DR STE 102
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-8057
Country	:	US
Telephone Number	:	772-873-3838
Fax Number	:	772-873-3839

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. SUSAN F. PERRY
Credential	:	MBA
Telephone Number	:	772-873-3838

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	10/25/2017

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