Healthcare Provider Details

I. General information

NPI: 1609720523
Provider Name (Legal Business Name): NEOMED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

J14 CALLE 9 URB SAN ANTONIO
COAMO PR
00769-2010
US

IV. Provider business mailing address

J14 CALLE 9
COAMO PR
00769-2010
US

V. Phone/Fax

Practice location:
  • Phone: 787-382-7175
  • Fax:
Mailing address:
  • Phone: 787-382-7175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: AIDA IVELISE COLON
Title or Position: PRESIDENTE
Credential: RT
Phone: 787-382-7175