MEDICARE: HOME DOC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1538870530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME DOC

Provider Business Mailing Address
First Line	:	475 BRICKELL AVE APT 2913
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2596
Country	:	US
Telephone Number	:	352-318-8416
Fax Number	:

Provider Business Practice Location Address
First Line	:	475 BRICKELL AVE APT 2913
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2596
Country	:	US
Telephone Number	:	352-318-8416
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALAN-MICHAEL PRICE
Credential	:
Telephone Number	:	352-318-8416

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	12/09/2022

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Directions to “HOME DOC ” Practice Location

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