Healthcare Provider Details

I. General information

NPI: 1124702279
Provider Name (Legal Business Name): EMINENT HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8785 SW 165TH AVE STE 2005
MIAMI FL
33193-5826
US

IV. Provider business mailing address

8785 SW 165TH AVE STE 2005
MIAMI FL
33193-5826
US

V. Phone/Fax

Practice location:
  • Phone: 786-347-2700
  • Fax: 305-456-9620
Mailing address:
  • Phone: 786-347-2700
  • Fax: 305-456-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEMYS GONZALEZ
Title or Position: ADMINISTRATOR, OWNER
Credential: RN
Phone: 786-347-2700