Provider Demographics
NPI:1477860336
Name:ELITE QUALITY CARE INC
Entity Type:Organization
Organization Name:ELITE QUALITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P
Authorized Official - Prefix:
Authorized Official - First Name:ELDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:TUESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-335-5115
Mailing Address - Street 1:11119 SW 147TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3316
Mailing Address - Country:US
Mailing Address - Phone:305-335-5115
Mailing Address - Fax:305-385-3037
Practice Address - Street 1:11119 SW 147TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3316
Practice Address - Country:US
Practice Address - Phone:305-335-5115
Practice Address - Fax:305-385-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229682253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001923300Medicaid