Healthcare Provider Details

I. General information

NPI: 1497943401
Provider Name (Legal Business Name): ROSAIDA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4163 NW 135TH ST
OPA LOCKA FL
33054-4658
US

IV. Provider business mailing address

4163 NW 135TH ST
OPA LOCKA FL
33054-4658
US

V. Phone/Fax

Practice location:
  • Phone: 305-688-8906
  • Fax: 305-688-0906
Mailing address:
  • Phone: 305-688-8906
  • Fax: 305-688-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number684905996
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299993062
License Number StateFL

VIII. Authorized Official

Name: MRS. IDA ESPINOSA
Title or Position: PRESIDENT
Credential: CNA
Phone: 305-688-8906