Healthcare Provider Details

I. General information

NPI: 1114166493
Provider Name (Legal Business Name): SANTA CLARA HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 COLLINS AVE CU-1
MIAMI BEACH FL
33140-2456
US

IV. Provider business mailing address

5601 COLLINS AVE CU-1
MIAMI BEACH FL
33140-2456
US

V. Phone/Fax

Practice location:
  • Phone: 305-993-5558
  • Fax: 305-993-5517
Mailing address:
  • Phone: 305-993-5558
  • Fax: 305-993-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: HENRY LORA
Title or Position: PHYSISICAN
Credential: MD
Phone: 305-993-5558