MEDICARE: HOME NURSE CORP.

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	HHA299992165	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HHA299992165	OTHER	FL	STATE OF FLORIDA LICENSE

General Provider Information

NPI Number	:	1871586503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME NURSE CORP.

Provider Business Mailing Address
First Line	:	10850 SW 113TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3227
Country	:	US
Telephone Number	:	305-275-2533
Fax Number	:	305-270-7037

Provider Business Practice Location Address
First Line	:	16102 EMERALD ESTATES DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-6118
Country	:	US
Telephone Number	:	954-349-4855
Fax Number	:	954-332-9344

Authorized Official
Title or Position	:	ADMINISTRATOR/GENERAL MANAGER
Name	:	JULIO CESAR CHACON
Credential	:
Telephone Number	:	305-275-2533

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	05/20/2009

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Directions to “HOME NURSE CORP. ” Practice Location

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