=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497943401
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROSAIDA HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2007
-----------------------------------------------------
Last Update Date | 03/27/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4163 NW 135TH ST
-----------------------------------------------------
City | OPA LOCKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33054-4658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-688-8906
-----------------------------------------------------
Fax | 305-688-0906
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4163 NW 135TH ST
-----------------------------------------------------
City | OPA LOCKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33054-4658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-688-8906
-----------------------------------------------------
Fax | 305-688-0906
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. IDA ESPINOSA
-----------------------------------------------------
Credential | CNA
-----------------------------------------------------
Telephone | 305-688-8906
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299993062
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number | 684905996
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------