Healthcare Provider Details

I. General information

NPI: 1457610982
Provider Name (Legal Business Name): S & Y INVESTMENT OF SOUTH FLORIDA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14331 SW 120TH ST UNIT 109
MIAMI FL
33186-7293
US

IV. Provider business mailing address

14331 SW 120TH ST UNIT 109
MIAMI FL
33186-7293
US

V. Phone/Fax

Practice location:
  • Phone: 786-518-3387
  • Fax: 786-518-3478
Mailing address:
  • Phone: 786-518-3387
  • Fax: 786-518-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: MRS. SRIDEIVIS DORTA
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 786-518-3387