Provider Demographics
NPI:1093741795
Name:PREFERRED HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-665-9919
Mailing Address - Street 1:4913 SW 74TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4412
Mailing Address - Country:US
Mailing Address - Phone:305-665-9919
Mailing Address - Fax:305-665-2025
Practice Address - Street 1:4913 SW 74TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4412
Practice Address - Country:US
Practice Address - Phone:305-665-9919
Practice Address - Fax:305-665-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991125251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650941000OtherMEDICAID LICENSE
FL650941000Medicaid