Healthcare Provider Details
I. General information
NPI: 1700394228
Provider Name (Legal Business Name): BARZAGA CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2018
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18646 NW 53RD AVE
MIAMI GARDENS FL
33055-5307
US
IV. Provider business mailing address
18646 NW 53RD AVE
MIAMI GARDENS FL
33055-5307
US
V. Phone/Fax
- Phone: 786-458-0031
- Fax:
- Phone: 786-458-0031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YAQUELIN
DIAZ BARZAGA
Title or Position: CEO
Credential: OWNER
Phone: 786-458-0031