Provider Demographics
NPI:1033576707
Name:MIMAS CARE INC
Entity Type:Organization
Organization Name:MIMAS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ FONSECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-307-3759
Mailing Address - Street 1:12892 SW 12TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2245
Mailing Address - Country:US
Mailing Address - Phone:786-307-3759
Mailing Address - Fax:786-364-1492
Practice Address - Street 1:53 W 21ST ST STE 10
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010
Practice Address - Country:US
Practice Address - Phone:786-655-0182
Practice Address - Fax:786-364-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health