Healthcare Provider Details

I. General information

NPI: 1558096248
Provider Name (Legal Business Name): PROKIDZ HEALTH CARE SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 10/08/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15260 SW 280TH ST. SUITE 201
HOMESTEAD FL
33032-8187
US

IV. Provider business mailing address

15260 SW 280TH ST. SUITE 201
HOMESTEAD FL
33032-8187
US

V. Phone/Fax

Practice location:
  • Phone: 407-800-6086
  • Fax: 305-230-2038
Mailing address:
  • Phone: 407-800-6086
  • Fax: 305-230-2038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ISVEL DELGADO RODRIGUEZ
Title or Position: OWNER, VP
Credential:
Phone: 407-800-6086