Provider Demographics
NPI:1356454482
Name:HOME HEALTH SERVICES OF SOUTH FLORIDA, INC.
Entity Type:Organization
Organization Name:HOME HEALTH SERVICES OF SOUTH FLORIDA, INC.
Other - Org Name:USA HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-889-5332
Mailing Address - Street 1:780 NW 42ND AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5536
Mailing Address - Country:US
Mailing Address - Phone:305-889-5332
Mailing Address - Fax:305-883-2991
Practice Address - Street 1:780 NW 42ND AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5536
Practice Address - Country:US
Practice Address - Phone:305-889-5332
Practice Address - Fax:305-883-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21222096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650987800Medicaid
FL650987800Medicaid