Healthcare Provider Details
I. General information
NPI: 1255425195
Provider Name (Legal Business Name): CARE ONE HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1535 SW 87TH AVE
MIAMI FL
33174-3312
US
IV. Provider business mailing address
1535 SW 87TH AVE
MIAMI FL
33174-3312
US
V. Phone/Fax
- Phone: 305-228-0301
- Fax: 305-228-0360
- Phone: 305-228-0301
- Fax: 305-228-0360
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 299992102 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CRISTIAN
FERNANDEZ-BANGO
Title or Position: MANAGER/CFO
Credential:
Phone: 305-228-0301