Healthcare Provider Details

I. General information

NPI: 1679724850
Provider Name (Legal Business Name): ST. SOPHIA NURSING CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 10/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 SW 57TH AVE
MIAMI FL
33144-3922
US

IV. Provider business mailing address

702 SW 57TH AVE
MIAMI FL
33144-3922
US

V. Phone/Fax

Practice location:
  • Phone: 305-265-3239
  • Fax: 305-265-3240
Mailing address:
  • Phone: 305-265-3239
  • Fax: 305-265-3240

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: DEYANIRA GUTIERREZ
Title or Position: ADMINISTRATOR/DON
Credential: RN
Phone: 305-265-3239