MEDICARE: LLERENA HOME HEALTH CARE 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	HHA299992324	FL

General Provider Information

NPI Number	:	1336193408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LLERENA HOME HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	2500 SW 107TH AVE
Second Line	:	SUITE 37
City	:	MIAMI
State	:	FL
Zip	:	33165-2470
Country	:	US
Telephone Number	:	305-228-5800
Fax Number	:	866-390-3568

Provider Business Practice Location Address
First Line	:	2500 SW 107TH AVE
Second Line	:	SUITE 37
City	:	MIAMI
State	:	FL
Zip	:	33165-2470
Country	:	US
Telephone Number	:	305-228-5800
Fax Number	:	866-390-3562

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LISET LLERENA
Credential	:
Telephone Number	:	305-228-5800

Provider Enumeration Date	:	05/21/2006
Last Update Date	:	06/05/2008

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