MEDICARE: PINES HOME HEALTH CARE SERVICES INC

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	:	1336127893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINES HOME HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	5400 S UNIVERSITY DR
Second Line	:	SUITE 409
City	:	DAVIE
State	:	FL
Zip	:	33328-5312
Country	:	US
Telephone Number	:	954-680-3898
Fax Number	:	954-680-3977

Provider Business Practice Location Address
First Line	:	5400 S UNIVERSITY DR
Second Line	:	SUITE 409
City	:	DAVIE
State	:	FL
Zip	:	33328-5312
Country	:	US
Telephone Number	:	954-680-3898
Fax Number	:	954-680-3977

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LYDIA AGUINALDO
Credential	:	REGISTERED NURSE
Telephone Number	:	954-680-3898

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	08/22/2020

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