Provider Demographics
NPI:1043355720
Name:MCDS HOME HEALTH GROUP, CORP.
Entity Type:Organization
Organization Name:MCDS HOME HEALTH GROUP, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-6966
Mailing Address - Street 1:17690 NW 78TH AVE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3668
Mailing Address - Country:US
Mailing Address - Phone:305-557-6966
Mailing Address - Fax:305-557-6841
Practice Address - Street 1:17690 NW 78TH AVE
Practice Address - Street 2:UNIT 103
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3668
Practice Address - Country:US
Practice Address - Phone:305-557-6966
Practice Address - Fax:305-557-6841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992638251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109062Medicare Oscar/Certification