MEDICARE: BACK 2 FUNCTION HOME 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

General Provider Information

NPI Number	:	1346314788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK 2 FUNCTION HOME CARE, INC.

Provider Business Mailing Address
First Line	:	2632 HOLLYWOOD BLVD
Second Line	:	SUITE 303
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4847
Country	:	US
Telephone Number	:	954-923-3233
Fax Number	:	954-923-3272

Provider Business Practice Location Address
First Line	:	2632 HOLLYWOOD BLVD
Second Line	:	SUITE 303
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4847
Country	:	US
Telephone Number	:	954-923-3233
Fax Number	:	954-923-3272

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ISABEL VELASCO
Credential	:
Telephone Number	:	954-923-3233

Provider Enumeration Date	:	11/18/2006
Last Update Date	:	08/22/2020

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