Healthcare Provider Details

I. General information

NPI: 1982904694
Provider Name (Legal Business Name): NATY HOME CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 SW 127TH PL
MIAMI FL
33175-6231
US

IV. Provider business mailing address

5402 SW 127TH PL
MIAMI FL
33175-6231
US

V. Phone/Fax

Practice location:
  • Phone: 305-603-7996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ALFREDO MARTIN MOJENA RODRIGUEZ
Title or Position: ADMINISTRATIVE
Credential:
Phone: 305-603-7996