MEDICARE: MAYON HEALTHCARE& STAFFING SERVICES

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	30211502	FL

General Provider Information

NPI Number	:	1649564030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYON HEALTHCARE& STAFFING SERVICES

Provider Business Mailing Address
First Line	:	18350 NW 2ND AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:	305-974-4294
Fax Number	:	305-974-4647

Provider Business Practice Location Address
First Line	:	18350 NW 2ND AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:	305-974-4294
Fax Number	:	305-974-4647

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MABEL UCHENNA ONOH
Credential	:
Telephone Number	:	954-699-4020

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	06/03/2011

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