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General NPI Number Information
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NPI Number | 1356454870
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Entity Type | Organization
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Legal Business Name | SOUTH KENDALL HOME CARE, LLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 12595 SW 137 AVE. SUITE 101
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 305-382-9474
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Fax | 305-382-9475
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Provider Business Mailing Address
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Address Line | 12595 SW 137 AVE. SUITE 101
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 305-382-9474
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Fax | 305-382-9475
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YOHANDYS VILLAR
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Credential |
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Telephone | 305-382-9474
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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 | 299992221
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License Number State | FL
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