Provider Demographics
NPI:1427181247
Name:SANTA TERESITA HOME CARE,CORP.
Entity Type:Organization
Organization Name:SANTA TERESITA HOME CARE,CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT.OWNER.CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HERMINIA
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-232-4805
Mailing Address - Street 1:13370 SW 128TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5807
Mailing Address - Country:US
Mailing Address - Phone:305-232-4805
Mailing Address - Fax:305-232-4806
Practice Address - Street 1:13370 SW 128TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5807
Practice Address - Country:US
Practice Address - Phone:305-232-4805
Practice Address - Fax:305-232-4806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
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
FL108233Medicare ID - Type Unspecified