Provider Demographics
NPI:1164694360
Name:FLORIDIAN HOME HEALTH CARE CORP
Entity Type:Organization
Organization Name:FLORIDIAN HOME HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-824-0280
Mailing Address - Street 1:4445 W 16TH AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7803
Mailing Address - Country:US
Mailing Address - Phone:305-824-0280
Mailing Address - Fax:305-824-0281
Practice Address - Street 1:4445 W 16TH AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7803
Practice Address - Country:US
Practice Address - Phone:305-824-0280
Practice Address - Fax:305-824-0281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherPENDING
FL109380Medicare Oscar/Certification