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General NPI Number Information
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NPI Number | 1306904602
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Entity Type | Organization
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Legal Business Name | SAMY NURSING CORP
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 4980 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33012-3726
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Country | US
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Telephone | 305-828-1396
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Fax | 305-825-1963
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Provider Business Mailing Address
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Address Line | 4980 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33012-3726
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Country | US
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Telephone | 305-828-1396
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Fax | 305-825-1963
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ERNESTO DIAZ
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Credential |
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Telephone | 305-828-1396
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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 | 299992574
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License Number State | FL
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