Healthcare Provider Details

I. General information

NPI: 1699130401
Provider Name (Legal Business Name): INTERNATIONAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2015
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5038 CALLE AHLELI
MAYAGUEZ PR
00682-1272
US

IV. Provider business mailing address

5038 CALLE AHLELI
MAYAGUEZ PR
00682-1272
US

V. Phone/Fax

Practice location:
  • Phone: 939-865-8020
  • Fax:
Mailing address:
  • Phone: 939-865-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StatePR
# 4
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StatePR

VIII. Authorized Official

Name: MR. CESAR A SANTOS SEDA
Title or Position: CEO
Credential:
Phone: 939-865-8020