MEDICARE: TRANSFORMATION HEALTH SPRING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133NN1002X	Nutrition Education Nutritionist
2	251J00000X	Nursing Care Agency
3	261QH0100X	Health Service Clinic/Center
4	405300000X	Prevention Professional

General Provider Information

NPI Number	:	1477240331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSFORMATION HEALTH SPRING

Provider Business Mailing Address
First Line	:	280 NW 144TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33168-4142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 NW 144TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33168-4142
Country	:	US
Telephone Number	:	305-921-4997
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. GINETTE DESIR
Credential	:
Telephone Number	:	305-921-4997

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	04/20/2023

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Directions to “TRANSFORMATION HEALTH SPRING ” Practice Location

Language	Start Address	Practice Location

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