Provider Demographics
NPI:1275745390
Name:ANDIV HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ANDIV HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-242-2282
Mailing Address - Street 1:12175 SW 132ND CT UNIT 9
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6410
Mailing Address - Country:US
Mailing Address - Phone:786-242-2282
Mailing Address - Fax:786-242-0922
Practice Address - Street 1:12175 SW 132ND CT UNIT 9
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6410
Practice Address - Country:US
Practice Address - Phone:786-242-2282
Practice Address - Fax:786-242-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992742251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health