Healthcare Provider Details

I. General information

NPI: 1932342003
Provider Name (Legal Business Name): SOUTH FLORIDA NURSE HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2009
Last Update Date: 04/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13155 SW 134TH ST SUITE 112
MIAMI FL
33186-4486
US

IV. Provider business mailing address

13155 SW 134TH ST SUITE 112
MIAMI FL
33186-4486
US

V. Phone/Fax

Practice location:
  • Phone: 786-339-4776
  • Fax: 786-349-1239
Mailing address:
  • Phone: 786-339-4776
  • Fax: 786-349-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EDWIN RIVERA
Title or Position: PRESIDENT
Credential: RN
Phone: 786-339-4776