Healthcare Provider Details

I. General information

NPI: 1306080775
Provider Name (Legal Business Name): MOUNT SINAI HOME HEALTH AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 NW 7TH ST SUITE 102
MIAMI FL
33125-3479
US

IV. Provider business mailing address

2001 NW 7TH ST SUITE 102
MIAMI FL
33125-3479
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-0603
  • Fax: 305-642-0390
Mailing address:
  • Phone: 305-642-0603
  • Fax: 305-642-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MAXIMILIANO S ALONSO
Title or Position: PRESIDENT
Credential:
Phone: 305-409-3320