Healthcare Provider Details

I. General information

NPI: 1104093830
Provider Name (Legal Business Name): TRINITY HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 W 84TH ST SUITE 103
HIALEAH GARDENS FL
33018-4924
US

IV. Provider business mailing address

3450 W 84TH ST SUITE 103
HIALEAH FL
33018-4924
US

V. Phone/Fax

Practice location:
  • Phone: 305-888-8902
  • Fax: 305-888-8903
Mailing address:
  • Phone: 305-888-8902
  • Fax: 305-888-8903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number299993264
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number299993264
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number299993264
License Number StateFL

VIII. Authorized Official

Name: MS. DIANA VALBUENA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 305-888-8902