Healthcare Provider Details

I. General information

NPI: 1255714283
Provider Name (Legal Business Name): HOMESTEAD HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 BAPTIST WAY
HOMESTEAD FL
33033-7600
US

IV. Provider business mailing address

975 BAPTIST WAY
HOMESTEAD FL
33033-7600
US

V. Phone/Fax

Practice location:
  • Phone: 786-243-8529
  • Fax: 786-243-8577
Mailing address:
  • Phone: 786-243-8529
  • Fax: 786-243-8577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH11482
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH11482
License Number StateFL

VIII. Authorized Official

Name: MARIE-ELSIE ADE
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 786-243-8529