Provider Demographics
NPI:1407941735
Name:HEARTBEAT HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:HEARTBEAT HOME HEALTH AGENCY, INC.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DON/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDENIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-201-3798
Mailing Address - Street 1:11420 N KENDALL DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1039
Mailing Address - Country:US
Mailing Address - Phone:305-979-1031
Mailing Address - Fax:786-201-3798
Practice Address - Street 1:11420 N KENDALL DR
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1039
Practice Address - Country:US
Practice Address - Phone:305-979-1031
Practice Address - Fax:786-201-3798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299992603OtherHOME HEALTH LICENSE
FL10-9083OtherMEDICARE CERTIFICATION NUMBER (CCN)
FL466696OtherJOINT COMMISSION ID #
FL651516900Medicaid