Provider Demographics
NPI:1336127893
Name:PINES HOME HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:PINES HOME HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUINALDO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:954-680-3898
Mailing Address - Street 1:5400 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 409
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5312
Mailing Address - Country:US
Mailing Address - Phone:954-680-3898
Mailing Address - Fax:954-680-3977
Practice Address - Street 1:5400 S UNIVERSITY DR
Practice Address - Street 2:SUITE 409
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5312
Practice Address - Country:US
Practice Address - Phone:954-680-3898
Practice Address - Fax:954-680-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107780Medicare ID - Type Unspecified