Healthcare Provider Details

I. General information

NPI: 1669636684
Provider Name (Legal Business Name): HEARTWELL HOME HEALTH CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NW 79TH AVE STE 116
DORAL FL
33122-1075
US

IV. Provider business mailing address

2500 NW 79TH AVE STE 116
DORAL FL
33122-1075
US

V. Phone/Fax

Practice location:
  • Phone: 305-591-7898
  • Fax:
Mailing address:
  • Phone: 305-591-7898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CLEMENTE SIERRA
Title or Position: CFO, ALTERNATIVE ADMINISTRATOR, CO-
Credential:
Phone: 305-591-7898