=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447409107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | XCELLENT HOME HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2008
-----------------------------------------------------
Last Update Date | 09/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3350 SW 148TH AVE SUITE 220
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33027-3257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-734-2774
-----------------------------------------------------
Fax | 954-874-2821
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3350 SW 148TH AVE SUITE 220
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33027-3257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-734-2774
-----------------------------------------------------
Fax | 954-874-2821
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MICHAEL M TORRES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-734-2774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------