MEDICARE: LAS MERCEDES HOME CARE 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
1	251E00000X	Home Health Agency	HHA20640096	FL
2	251E00000X	Home Health Agency	HHA20640096(HOMEHEAL	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346257235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS MERCEDES HOME CARE CORP

Provider Business Mailing Address
First Line	:	2103 CORAL WAY
Second Line	:	SUITE 107
City	:	MIAMI
State	:	FL
Zip	:	33145
Country	:	US
Telephone Number	:	305-857-9808
Fax Number	:	305-857-9906

Provider Business Practice Location Address
First Line	:	2103 CORAL WAY
Second Line	:	SUITE 107
City	:	MIAMI
State	:	FL
Zip	:	33145
Country	:	US
Telephone Number	:	305-857-9808
Fax Number	:	305-857-9906

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. FRANCIS J TRULLENQUE
Credential	:
Telephone Number	:	305-857-9808

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	05/12/2009

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Directions to “LAS MERCEDES HOME CARE CORP ” Practice Location

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