MEDICARE: ECG HOME COMPANION, 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	3747A0650X	Attendant Care Provider
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1215632989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECG HOME COMPANION, LLC

Provider Business Mailing Address
First Line	:	2686 SW 28TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3135
Country	:	US
Telephone Number	:	786-587-7661
Fax Number	:

Provider Business Practice Location Address
First Line	:	2686 SW 28TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3135
Country	:	US
Telephone Number	:	305-960-7638
Fax Number	:	786-364-1616

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ELENA FERNANDEZ
Credential	:
Telephone Number	:	786-393-8122

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	12/07/2023

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Directions to “ECG HOME COMPANION, LLC ” Practice Location

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