MEDICARE: INDEPENDENT HOME CARE 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	:	1922285048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENT HOME CARE INC

Provider Business Mailing Address
First Line	:	13899 BISCAYNE BLVD STE 145
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33181-1650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13899 BISCAYNE BLVD STE 145
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33181-1650
Country	:	US
Telephone Number	:	305-702-6320
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	PAVEL ELBERG
Credential	:
Telephone Number	:	614-266-3228

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	01/31/2008

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