MEDICARE: HOME HEALTH CARE SERVICES OF SOUTH FLORIDA CORP

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	332B00000X	Durable Medical Equipment & Medical Supplies

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PENDING MEDICARE #	OTHER	FL	PENDING MEDICARE #

General Provider Information

NPI Number	:	1538302328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH CARE SERVICES OF SOUTH FLORIDA CORP

Provider Business Mailing Address
First Line	:	398 NE 79TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-4821
Country	:	US
Telephone Number	:	305-986-6316
Fax Number	:

Provider Business Practice Location Address
First Line	:	398 NE 79TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-4821
Country	:	US
Telephone Number	:	305-986-6316
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAGDIEL FERNANDEZ
Credential	:
Telephone Number	:	305-986-6316

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	04/09/2009

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