Provider Demographics
NPI:1134326630
Name:SOUTH FLORIDA HOME SERVICES INC.
Entity Type:Organization
Organization Name:SOUTH FLORIDA HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-312-4259
Mailing Address - Street 1:140 N.W. 9 AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1317
Mailing Address - Country:US
Mailing Address - Phone:305-324-7198
Mailing Address - Fax:305-324-7198
Practice Address - Street 1:140 N.W. 9 AVE.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1317
Practice Address - Country:US
Practice Address - Phone:305-324-7198
Practice Address - Fax:305-324-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141046600Medicaid