Healthcare Provider Details
I. General information
NPI: 1962203349
Provider Name (Legal Business Name): MDHOME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 SW 23RD RD
MIAMI FL
33129-1933
US
IV. Provider business mailing address
825 SW 23RD RD
MIAMI FL
33129-1933
US
V. Phone/Fax
- Phone: 917-601-8706
- Fax:
- Phone: 917-601-8706
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SETH
JEREMY
MARQUIT
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-343-2974