Provider Demographics
NPI:1164191383
Name:MIAMI SPECIAL HOME CARE, LLC
Entity Type:Organization
Organization Name:MIAMI SPECIAL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-278-0720
Mailing Address - Street 1:8415 SW 107TH AVE APT 235W
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4305
Mailing Address - Country:US
Mailing Address - Phone:786-278-0720
Mailing Address - Fax:786-536-4427
Practice Address - Street 1:1335 NW 98TH CT UNIT 5
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2778
Practice Address - Country:US
Practice Address - Phone:786-278-0720
Practice Address - Fax:786-536-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care