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General NPI Number Information
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NPI Number | 1184787301
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Entity Type | Organization
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Legal Business Name | MIRACLE BLESSED CARE ENTERPRISES, INC.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 548 HIALEAH DR
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City | HIALEAH
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State | FL
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Zip | 33010-5349
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Country | US
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Telephone | 305-887-6255
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Fax | 305-887-6242
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Provider Business Mailing Address
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Address Line | 548 HIALEAH DR
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City | HIALEAH
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State | FL
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Zip | 33010-5349
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Country | US
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Telephone | 305-887-6255
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Fax | 305-887-6242
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Authorized Official
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Title or Position | RN
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Name | MRS. AYMARA PATRON
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Credential |
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Telephone | 305-887-6255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 21578096
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License Number State | FL
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