Healthcare Provider Details

I. General information

NPI: 1922460849
Provider Name (Legal Business Name): ELITE HOMECARE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 NE 125TH ST
NORTH MIAMI FL
33161-5611
US

IV. Provider business mailing address

707 NE 125TH ST
NORTH MIAMI FL
33161-5611
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-9848
  • Fax: 305-400-8113
Mailing address:
  • Phone: 305-902-9848
  • Fax: 305-400-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRITZNER CHARLES
Title or Position: PRESIDENT
Credential:
Phone: 305-902-9848