MEDICARE: M HOME CARE 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	:	1962955336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M HOME CARE LLC

Provider Business Mailing Address
First Line	:	7349 PARAGON RD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34291-5748
Country	:	US
Telephone Number	:	201-937-4636
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 PARAGON RD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34291-5748
Country	:	US
Telephone Number	:	201-937-4636
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	MRS. VALENTINA ROYZMAN
Credential	:
Telephone Number	:	201-937-4636

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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