Provider Demographics
NPI:1235300856
Name:BREEZE HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:BREEZE HOME HEALTH AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAYANYS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-271-2947
Mailing Address - Street 1:9240 SW 72 ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3262
Mailing Address - Country:US
Mailing Address - Phone:305-271-2947
Mailing Address - Fax:305-271-2977
Practice Address - Street 1:9240 SW 72 ST
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3262
Practice Address - Country:US
Practice Address - Phone:305-271-2947
Practice Address - Fax:305-271-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109189Medicare PIN