MEDICARE: MAGIC HOME HEALTH CARE

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	:	1396338638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGIC HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	5242 BRACKS LANDING DR
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8064
Country	:	US
Telephone Number	:	787-383-1437
Fax Number	:

Provider Business Practice Location Address
First Line	:	5242 BRACKS LANDING DR
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8064
Country	:	US
Telephone Number	:	787-383-1437
Fax Number	:

Authorized Official
Title or Position	:	NURSE ADMINISTRADOR
Name	:	MR. KEVIN O RIVERA SR.
Credential	:	RN
Telephone Number	:	787-383-1437

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	02/20/2021

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Directions to “MAGIC HOME HEALTH CARE ” Practice Location

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