MEDICARE: MANICANA HOME HEALTH AGENCY 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	:	1376658450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANICANA HOME HEALTH AGENCY INC.

Provider Business Mailing Address
First Line	:	633 NE 167TH ST
Second Line	:	SUITE # 622
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33162-2442
Country	:	US
Telephone Number	:	305-654-0043
Fax Number	:	305-654-0049

Provider Business Practice Location Address
First Line	:	633 NE 167TH ST
Second Line	:	SUITE # 622
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33162-2442
Country	:	US
Telephone Number	:	305-654-0043
Fax Number	:	305-654-0049

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. NICOLAS ANTOINE FARANO
Credential	:
Telephone Number	:	305-654-0043

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	08/22/2020

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