MEDICARE: PALM BEACH HOME HEALTH INC

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		FL

General Provider Information

NPI Number	:	1558450643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH HOME HEALTH INC

Provider Business Mailing Address
First Line	:	201 OHIO RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-4821
Country	:	US
Telephone Number	:	561-963-5544
Fax Number	:	561-963-1883

Provider Business Practice Location Address
First Line	:	2150 S CONGRESS AVE
Second Line	:
City	:	W PALM BEACH
State	:	FL
Zip	:	33406-4821
Country	:	US
Telephone Number	:	561-963-5544
Fax Number	:	561-963-1883

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JUAN RODRIGUEZ
Credential	:
Telephone Number	:	561-963-5544

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/22/2020

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