Provider Demographics
NPI:1073759924
Name:DADE FAMILY PROFESSIONAL SERVICES ,LLC
Entity Type:Organization
Organization Name:DADE FAMILY PROFESSIONAL SERVICES ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:SR
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-559-6363
Mailing Address - Street 1:2711 SW 137TH AVE
Mailing Address - Street 2:SUITE 89
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6359
Mailing Address - Country:US
Mailing Address - Phone:305-559-6363
Mailing Address - Fax:305-559-6364
Practice Address - Street 1:2711 SW 137TH AVE
Practice Address - Street 2:SUITE 89
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6359
Practice Address - Country:US
Practice Address - Phone:305-559-6363
Practice Address - Fax:305-559-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health