MEDICARE: COSTA HEALTH SERVICES 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

General Provider Information

NPI Number	:	1801309927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COSTA HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	230 SW 12TH ST APT 708
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4298
Country	:	US
Telephone Number	:	786-715-4388
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 SW 12TH ST APT 708
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4298
Country	:	US
Telephone Number	:	786-715-4388
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. YAUMARA ORAMA
Credential	:
Telephone Number	:	786-715-4388

Provider Enumeration Date	:	11/11/2017
Last Update Date	:	11/11/2017

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Directions to “COSTA HEALTH SERVICES INC ” Practice Location

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