=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508651639
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARASUL HOME HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2025
-----------------------------------------------------
Last Update Date | 05/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 455 W 23RD ST UNIT 9
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33010-1415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-720-6411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4701 W 4TH AVE
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33012-3938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-720-6411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | YANETSI ALVAREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-720-6411
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------