Healthcare Provider Details

I. General information

NPI: 1427963164
Provider Name (Legal Business Name): ELITE HOME PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16672 SW 92ND ST
MIAMI FL
33196-1083
US

IV. Provider business mailing address

16672 SW 92ND ST
MIAMI FL
33196-1083
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-2753
  • Fax:
Mailing address:
  • Phone: 786-521-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YINDRA ISAAC AMADOR
Title or Position: MANAGER
Credential: AGACNP-FNP-BC
Phone: 786-521-2753