Provider Demographics
NPI:1437131059
Name:MOUNT AUBURN, INC.
Entity Type:Organization
Organization Name:MOUNT AUBURN, INC.
Other - Org Name:MOUNT AUBURN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-917-0363
Mailing Address - Street 1:5790 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4210
Mailing Address - Country:US
Mailing Address - Phone:305-917-0363
Mailing Address - Fax:305-917-0368
Practice Address - Street 1:5790 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4210
Practice Address - Country:US
Practice Address - Phone:305-917-0363
Practice Address - Fax:305-917-0368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA219830961251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107542Medicare ID - Type UnspecifiedPROVIDER NUMBER