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General NPI Number Information
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NPI Number | 1043479140
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Entity Type | Organization
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Legal Business Name | ORTA'S HOME, INC.
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 1201 NW 35TH AVENUE
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City | MIAMI
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State | FL
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Zip | 33125-2855
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Country | US
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Telephone | 786-515-7715
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Fax | 305-262-3844
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Provider Business Mailing Address
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Address Line | 1201 NW 35TH AVENUE
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City | MIAMI
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State | FL
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Zip | 33125-2855
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Country | US
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Telephone | 786-515-7715
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Fax | 305-262-3844
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ANA CECILIA HERNANDEZ
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Credential |
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Telephone | 786-515-7715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6905079
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License Number State | FL
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