MEDICARE: ELITE SUPPORT CARE

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	251J00000X	Nursing Care Agency	0499593517345	FL
2	385H00000X	Respite Care	0499593517345	FL
3	251E00000X	Home Health Agency	0499593517345	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063686822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE SUPPORT CARE

Provider Business Mailing Address
First Line	:	10180 SW 28TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-2956
Country	:	US
Telephone Number	:	786-266-9057
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 182
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3002
Country	:	US
Telephone Number	:	786-266-9057
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LETICIA SANCHEZ
Credential	:
Telephone Number	:	786-266-9057

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	08/24/2021

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Directions to “ELITE SUPPORT CARE ” Practice Location

Language	Start Address	Practice Location

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