Healthcare Provider Details

I. General information

NPI: 1922927441
Provider Name (Legal Business Name): SOS PHYSIO HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W 16TH AVE STE 48
HIALEAH FL
33012-7193
US

IV. Provider business mailing address

4410 W 16TH AVE STE 48
HIALEAH FL
33012-7193
US

V. Phone/Fax

Practice location:
  • Phone: 305-306-8376
  • Fax: 305-570-2148
Mailing address:
  • Phone: 305-306-8376
  • Fax: 305-570-2148

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: MATVEY GORZHEVSKY
Title or Position: OWNER/PRESIDENT
Credential: PT
Phone: 786-651-1605