Healthcare Provider Details

I. General information

NPI: 1548576770
Provider Name (Legal Business Name): MY HOME ELDER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5856 W FLAGLER ST
MIAMI FL
33144-3363
US

IV. Provider business mailing address

5856 W FLAGLER ST
MIAMI FL
33144-3363
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-4412
  • Fax: 305-264-4408
Mailing address:
  • Phone: 305-264-4412
  • Fax: 305-264-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9133
License Number StateFL

VIII. Authorized Official

Name: MRS. MARIA ISABEL CARO
Title or Position: PRESIDENT
Credential:
Phone: 305-264-4412