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General NPI Number Information
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NPI Number | 1932396520
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Entity Type | Organization
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Legal Business Name | PRINCESS HOME HEALTH AGENCY INC.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 535 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3812
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Country | US
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Telephone | 305-693-3108
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Fax | 305-693-9825
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Provider Business Mailing Address
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Address Line | 535 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3812
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Country | US
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Telephone | 305-693-3108
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Fax | 305-693-9825
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Authorized Official
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Title or Position | DON
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Name | ELENA LUZ ROSELLO
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Credential | RN
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Telephone | 305-693-3108
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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 | 299992548
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License Number State | FL
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