MEDICARE: PAN AMERICAN HOSPITAL HOME HEALTH AGENCY

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	20898096	FL

General Provider Information

NPI Number	:	1508860149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAN AMERICAN HOSPITAL HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	815 NW 57TH AVE
Second Line	:	STE 114
City	:	MIAMI
State	:	FL
Zip	:	33126-2041
Country	:	US
Telephone Number	:	305-267-1515
Fax Number	:	305-266-7131

Provider Business Practice Location Address
First Line	:	815 NW 57TH AVE
Second Line	:	STE 114
City	:	MIAMI
State	:	FL
Zip	:	33126-2041
Country	:	US
Telephone Number	:	305-267-1515
Fax Number	:	305-266-7131

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. VICENTE SANCHEZ
Credential	:
Telephone Number	:	305-265-6469

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/22/2020

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