Healthcare Provider Details

I. General information

NPI: 1962116913
Provider Name (Legal Business Name): EXCELSIOR HOME CARESERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18441 NW 2ND AVE STE 103
MIAMI GARDENS FL
33169-4517
US

IV. Provider business mailing address

18441 NW 2ND AVE STE 103
MIAMI GARDENS FL
33169-4517
US

V. Phone/Fax

Practice location:
  • Phone: 305-650-1158
  • Fax: 305-705-4292
Mailing address:
  • Phone: 305-650-1158
  • Fax: 305-705-4292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ERNST FLEURANVIL
Title or Position: ADMINISTRATOR
Credential: P.E.
Phone: 347-339-6688