Provider Demographics
NPI:1477006211
Name:ACTIVE HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:ACTIVE HEALTH SOLUTIONS LLC
Other - Org Name:ACTIVE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MESSOD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENZAQUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-3449
Mailing Address - Street 1:11601 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3151
Mailing Address - Country:US
Mailing Address - Phone:786-360-3449
Mailing Address - Fax:786-536-4411
Practice Address - Street 1:11601 BISCAYNE BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:786-360-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211856251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health