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1720128887 NPI number — PROFESSIONAL MEDICAL HOME HEALTH LLC

NPI Number: 1720128887
Health Care Provider/Practitioner: PROFESSIONAL MEDICAL HOME HEALTH LLC

Information about “1720128887” NPI (PROFESSIONAL MEDICAL HOME HEALTH LLC) exists in 1720128887 in HTML format HTML  |  1720128887 in plain Text format TXT  |  1720128887 in PDF (Portable Document Format) PDF  |  1720128887 in an XML format XML  formats.

NPI Number : 1720128887 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720128887",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROFESSIONAL MEDICAL HOME HEALTH LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "930 HIALEAH DR",
    "SecondLineMailingAddress": "UNIT 14",
    "MailingAddressCityName": "HIALEAH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33010-5534",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-884-0409",
    "MailingAddressFaxNumber": "305-884-0410",
    "FirstLinePracticeLocationAddress": "930 HIALEAH DR",
    "SecondLinePracticeLocationAddress": "UNIT 14",
    "PracticeLocationAddressCityName": "HIALEAH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33010-5534",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-884-0409",
    "PracticeLocationAddressFaxNumber": "305-884-0410",
    "EnumerationDate": "02/07/2007",
    "LastUpdateDate": "01/14/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "VIVES",
    "AuthorizedOfficialFirstName": "FLOR",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "305-884-0409",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251E00000X",
        "TaxonomyName": "Home Health Agency",
        "LicenseNumber": "HHA299992614",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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