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General NPI Number Information
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NPI Number | 1679905780
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Entity Type | Organization
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Legal Business Name | MAGDOLNA HOME CARE INC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 372 SW TODD AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3061
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Country | US
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Telephone | 772-201-4856
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Fax |
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Provider Business Mailing Address
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Address Line | 372 SW TODD AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3061
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Country | US
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Telephone | 772-201-4856
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Fax |
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Authorized Official
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Title or Position | ADMNISTRATOR
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Name | MAGDOLNA SZABO
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Credential |
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Telephone | 772-201-4856
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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 | AL12060
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License Number State | FL
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