MEDICARE: PALM HEALTH AGENCY 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	:	1891959482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM HEALTH AGENCY INC

Provider Business Mailing Address
First Line	:	1765 W 41ST ST
Second Line	:	# 2C
City	:	HIALEAH
State	:	FL
Zip	:	33012-7019
Country	:	US
Telephone Number	:	305-409-0739
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2167
Country	:	US
Telephone Number	:	305-409-0739
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANA G LEON RAMOS
Credential	:
Telephone Number	:	305-409-0739

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	07/14/2008

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