=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205098274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANCA HOME HEALTH CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2008
-----------------------------------------------------
Last Update Date | 01/09/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2100 CORAL WAY SUITE 601
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33145-2635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-858-0779
-----------------------------------------------------
Fax | 305-858-4668
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2100 CORAL WAY SUITE 601
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33145-2635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-858-0779
-----------------------------------------------------
Fax | 305-858-4668
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. CARLOS R ABREU TOLEDO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-858-0779
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299993171
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------