Healthcare Provider Details

I. General information

NPI: 1710127667
Provider Name (Legal Business Name): PASSION CARE HOME HEALTH AGENCY INC. DBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/29/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 BLUE LAGOON DR STE 800
MIAMI FL
33126-7050
US

IV. Provider business mailing address

5201 BLUE LAGOON DR STE 800
MIAMI FL
33126-7050
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-8921
  • Fax: 305-728-2684
Mailing address:
  • Phone: 786-953-8921
  • Fax: 305-728-2684

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 Code251E00000X
TaxonomyHome Health Agency
License Number299993473
License Number StateFL

VIII. Authorized Official

Name: MAYPU MORELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-953-8921