MEDICARE: HOME HEALTH SMILES NORTH LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1205516556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH SMILES NORTH LLC

Provider Business Mailing Address
First Line	:	1421 SW 107TH AVE # 249
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-2526
Country	:	US
Telephone Number	:	305-302-7270
Fax Number	:

Provider Business Practice Location Address
First Line	:	1995 E OAKLAND PARK BLVD STE 210
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33306-1137
Country	:	US
Telephone Number	:	305-697-7023
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ERIC ANTHONY RATCHELL
Credential	:
Telephone Number	:	305-302-7270

Provider Enumeration Date	:	07/21/2023
Last Update Date	:	07/21/2023

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