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NPI Code Detail

MEDICARE: SAMY NURSING CORP

MEDICARE: SAMY NURSING 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
1251E00000XHome Health Agency299992574FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1299992574OTHERFLAHCA

General Provider Information

NPI Number : 1306904602
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMY NURSING CORP
Provider Business Mailing Address
First Line : 4980 PALM AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3726
Country : US
Telephone Number : 305-828-1396
Fax Number : 305-825-1963
Provider Business Practice Location Address
First Line : 4980 PALM AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3726
Country : US
Telephone Number : 305-828-1396
Fax Number : 305-825-1963
Authorized Official
Title or Position : PRESIDENT
Name : MR. ERNESTO DIAZ
Credential :
Telephone Number : 305-828-1396
Provider Enumeration Date : 12/05/2006
Last Update Date : 01/26/2010

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Directions to “SAMY NURSING CORP ” Practice Location

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