MEDICARE: MY FAMILY HOME CARE LLC

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

General Provider Information

NPI Number	:	1700416641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY FAMILY HOME CARE LLC

Provider Business Mailing Address
First Line	:	10029 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4623
Country	:	US
Telephone Number	:	305-412-3889
Fax Number	:	305-412-3888

Provider Business Practice Location Address
First Line	:	10029 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4623
Country	:	US
Telephone Number	:	305-412-3889
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FERNANDO CARLOS PEREZ
Credential	:
Telephone Number	:	305-412-3889

Provider Enumeration Date	:	01/20/2020
Last Update Date	:	01/20/2020

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Directions to “MY FAMILY HOME CARE LLC ” Practice Location

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