Healthcare Provider Details

I. General information

NPI: 1427952647
Provider Name (Legal Business Name): LEGACY ONE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8249 NW 36TH ST STE 111
DORAL FL
33166-6673
US

IV. Provider business mailing address

8249 NW 36TH ST STE 111
DORAL FL
33166-6673
US

V. Phone/Fax

Practice location:
  • Phone: 305-300-7884
  • Fax:
Mailing address:
  • Phone: 305-300-7884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: PEDRO RENE RAMOS SANTOS
Title or Position: OWNER
Credential:
Phone: 305-300-7884