MEDICARE: AMALTHEA HOME HEALTH AGENCY CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1043406135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMALTHEA HOME HEALTH AGENCY CORP

Provider Business Mailing Address
First Line	:	2100 W 76TH ST
Second Line	:	SUITE 312
City	:	HIALEAH
State	:	FL
Zip	:	33016-5500
Country	:	US
Telephone Number	:	305-819-4513
Fax Number	:	305-819-4876

Provider Business Practice Location Address
First Line	:	2100 W 76TH ST
Second Line	:	SUITE 312
City	:	HIALEAH
State	:	FL
Zip	:	33016-5500
Country	:	US
Telephone Number	:	305-819-4513
Fax Number	:	305-819-4876

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARIA CECILIA SUAREZ
Credential	:
Telephone Number	:	305-819-4513

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	03/14/2008

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