Provider Demographics
NPI:1043909096
Name:PHENIX NURSING CARE INC
Entity Type:Organization
Organization Name:PHENIX NURSING CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-345-6505
Mailing Address - Street 1:5951 NW 173RD DR UNIT 3B
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5126
Mailing Address - Country:US
Mailing Address - Phone:786-345-6505
Mailing Address - Fax:786-228-0053
Practice Address - Street 1:5951 NW 173RD DR UNIT 3B
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5126
Practice Address - Country:US
Practice Address - Phone:786-345-6505
Practice Address - Fax:786-228-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty