Provider Demographics
NPI:1235312646
Name:HEAD,HANDS,HEART HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:HEAD,HANDS,HEART HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N./D.O.N./ADMINISTRATOR/C.F.O.
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ-LARREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-826-9676
Mailing Address - Street 1:1790 W 49TH ST
Mailing Address - Street 2:SUITE #308
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2992
Mailing Address - Country:US
Mailing Address - Phone:305-826-9676
Mailing Address - Fax:305-826-4064
Practice Address - Street 1:1790 W 49TH ST
Practice Address - Street 2:SUITE #308
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2992
Practice Address - Country:US
Practice Address - Phone:305-826-9676
Practice Address - Fax:305-826-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health