Provider Demographics
NPI:1083720122
Name:AMERICAN PROUD HOME HEALTH CORP.
Entity Type:Organization
Organization Name:AMERICAN PROUD HOME HEALTH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-293-4938
Mailing Address - Street 1:8900 SW 117TH AVE
Mailing Address - Street 2:SUITE C101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2175
Mailing Address - Country:US
Mailing Address - Phone:786-293-4938
Mailing Address - Fax:786-293-4939
Practice Address - Street 1:8900 SW 117TH AVE
Practice Address - Street 2:SUITE C101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2175
Practice Address - Country:US
Practice Address - Phone:786-293-4938
Practice Address - Fax:786-293-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992489251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108479Medicare Oscar/Certification