Healthcare Provider Details

I. General information

NPI: 1134237324
Provider Name (Legal Business Name): JEM HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 NE MIAMI GARDENS DRIVE SUITE 205
MIAMI FL
33179
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DRIVE SUITE 205
MIAMI FL
33179
US

V. Phone/Fax

Practice location:
  • Phone: 305-949-8380
  • Fax: 305-949-4662
Mailing address:
  • Phone: 305-949-8380
  • Fax: 305-949-4662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: KHALED EL BEBLAWY
Title or Position: CEO
Credential:
Phone: 305-949-8380