Healthcare Provider Details

I. General information

NPI: 1215632989
Provider Name (Legal Business Name): ECG HOME COMPANION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2686 SW 28TH LN
MIAMI FL
33133-3135
US

IV. Provider business mailing address

2686 SW 28TH LN
MIAMI FL
33133-3135
US

V. Phone/Fax

Practice location:
  • Phone: 305-960-7638
  • Fax: 786-364-1616
Mailing address:
  • Phone: 786-587-7661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ELENA FERNANDEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-393-8122