Healthcare Provider Details

I. General information

NPI: 1982912424
Provider Name (Legal Business Name): NORTH MIAMI HEALTH SERVICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 NW 153RD ST SUITE G
MIAMI LAKES FL
33014-2419
US

IV. Provider business mailing address

6001 NW 153RD ST SUITE G
MIAMI LAKES FL
33014-2419
US

V. Phone/Fax

Practice location:
  • Phone: 786-970-2680
  • Fax: 877-815-8592
Mailing address:
  • Phone: 786-970-2680
  • Fax: 877-815-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number231093
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number231093
License Number StateFL

VIII. Authorized Official

Name: MRS. REGINA E LINARES
Title or Position: CNA
Credential: PRESIDENT
Phone: 786-970-2680