Provider Demographics
NPI:1083131239
Name:EYPR OME HEALTH CARE INC
Entity Type:Organization
Organization Name:EYPR OME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ENID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PEREZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-887-3114
Mailing Address - Street 1:PO BOX 51331
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33994-1331
Mailing Address - Country:US
Mailing Address - Phone:239-887-3114
Mailing Address - Fax:
Practice Address - Street 1:9850 BERNWOOD PLACE DR APT 109
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-6904
Practice Address - Country:US
Practice Address - Phone:239-887-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235005251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid