Healthcare Provider Details

I. General information

NPI: 1336128099
Provider Name (Legal Business Name): TENDRA HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 BLUE LAGOON DR STE 150
MIAMI FL
33126-2024
US

IV. Provider business mailing address

6161 BLUE LAGOON DR STE 150
MIAMI FL
33126-2024
US

V. Phone/Fax

Practice location:
  • Phone: 954-538-8588
  • Fax: 954-538-1414
Mailing address:
  • Phone: 305-696-2323
  • Fax: 305-696-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299992058
License Number StateFL

VIII. Authorized Official

Name: KELLY KASKAVAGE
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 214-575-2999