Provider Demographics
NPI:1245405810
Name:CAMAGUEY HOME CARE
Entity Type:Organization
Organization Name:CAMAGUEY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARTINEZ-TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-222-2263
Mailing Address - Street 1:7171 CORAL WAY
Mailing Address - Street 2:SUITE 417A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1449
Mailing Address - Country:US
Mailing Address - Phone:305-222-2262
Mailing Address - Fax:305-222-2262
Practice Address - Street 1:7171 CORAL WAY
Practice Address - Street 2:SUITE 417A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1449
Practice Address - Country:US
Practice Address - Phone:305-222-2262
Practice Address - Fax:305-222-2262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPPLYING FOR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPPLYING FORMedicaid