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General NPI Number Information
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NPI Number | 1811920317
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Entity Type | Organization
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Legal Business Name | PRO-HEALTH HOME SERVICES, INC.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 SW 1ST ST SUITE 308
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City | MIAMI
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State | FL
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Zip | 33135-1960
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Country | US
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Telephone | 305-649-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 SW 1 STREET SUITE 308
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City | MIAMI
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State | FL
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Zip | 33135
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Country | US
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Telephone | 305-649-7878
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | XIOMARA DIAZ
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Credential |
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Telephone | 305-649-7878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 1312379
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License Number State | FL
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