Provider Demographics
NPI:1225149834
Name:FLORIDA HOME HEALTH CARE PROVIDERS, INC.
Entity Type:Organization
Organization Name:FLORIDA HOME HEALTH CARE PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICENTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:TELLECHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-2112
Mailing Address - Street 1:4150 NW 7TH ST
Mailing Address - Street 2:SUITE # 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5535
Mailing Address - Country:US
Mailing Address - Phone:305-649-2112
Mailing Address - Fax:305-649-2128
Practice Address - Street 1:4150 NW 7TH ST
Practice Address - Street 2:SUITE # 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5535
Practice Address - Country:US
Practice Address - Phone:305-649-2112
Practice Address - Fax:305-649-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992127251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651246100Medicaid
FL10-8298Medicare ID - Type UnspecifiedHOME HEALTH