Healthcare Provider Details

I. General information

NPI: 1629077060
Provider Name (Legal Business Name): LOVING HEART HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 NW 93RD AVE
DORAL FL
33172-4811
US

IV. Provider business mailing address

2301 NW 93RD AVE
DORAL FL
33172-4811
US

V. Phone/Fax

Practice location:
  • Phone: 305-594-7200
  • Fax: 305-594-7227
Mailing address:
  • Phone: 305-594-7200
  • Fax: 305-594-7227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA216300951
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number677828300
License Number StateFL

VIII. Authorized Official

Name: JOAQUIN MARQUEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-594-7200