MEDICARE: IDEAL CHOICE HOME CARE AGENCY 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	:	1881260255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IDEAL CHOICE HOME CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	2577 SW 83RD AVE
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-7411
Country	:	US
Telephone Number	:	954-592-3968
Fax Number	:

Provider Business Practice Location Address
First Line	:	7951 RIVIERA BLVD STE 208
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-6437
Country	:	US
Telephone Number	:	954-592-3968
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT/ADMINISTRATOR
Name	:	ESTHER DUMOND
Credential	:
Telephone Number	:	954-592-3968

Provider Enumeration Date	:	05/27/2021
Last Update Date	:	06/30/2022

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