NPI Code Details Logo

NPI 1114835139

NPI 1114835139 : PUREHEART MEDICAL INC : HOMESTEAD, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1114835139
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PUREHEART MEDICAL INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/31/2026
-----------------------------------------------------
    Last Update Date     |    09/01/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    12100 SW 255TH ST 
-----------------------------------------------------
    City                 |    HOMESTEAD
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33032-6809
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    786-971-7920
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    12100 SW 255TH ST 
-----------------------------------------------------
    City                 |    HOMESTEAD
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33032-6809
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    786-971-7920
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OFFICER
-----------------------------------------------------
    Name                 |     ANNETTE  PEREZ 
-----------------------------------------------------
    Credential           |    RN
-----------------------------------------------------
    Telephone            |    786-971-7920
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    251J00000X
-----------------------------------------------------
    Taxonomy Name        |    Nursing Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.