Healthcare Provider Details

I. General information

NPI: 1215892245
Provider Name (Legal Business Name): ABRAZO VITAL HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9734 W 34TH CT
HIALEAH FL
33018-2017
US

IV. Provider business mailing address

9734 W 34TH CT
HIALEAH FL
33018-2017
US

V. Phone/Fax

Practice location:
  • Phone: 305-519-5681
  • Fax:
Mailing address:
  • Phone: 305-519-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUIS M RODRIGUEZ
Title or Position: MGR
Credential:
Phone: 305-519-5681