Provider Demographics
NPI:1235375882
Name:M & N PROFESSIONAL SERVICES HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:M & N PROFESSIONAL SERVICES HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIEZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-542-0159
Mailing Address - Street 1:4155 SW 130TH AVE
Mailing Address - Street 2:STE. 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3414
Mailing Address - Country:US
Mailing Address - Phone:786-542-0159
Mailing Address - Fax:786-542-0184
Practice Address - Street 1:4155 SW 130TH AVE
Practice Address - Street 2:STE. 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3414
Practice Address - Country:US
Practice Address - Phone:786-542-0159
Practice Address - Fax:786-542-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993502251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109584OtherMEDICARE