Provider Demographics
NPI:1508860149
Name:PAN AMERICAN HOSPITAL HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:PAN AMERICAN HOSPITAL HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-265-6469
Mailing Address - Street 1:815 NW 57TH AVE
Mailing Address - Street 2:STE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2041
Mailing Address - Country:US
Mailing Address - Phone:305-267-1515
Mailing Address - Fax:305-266-7131
Practice Address - Street 1:815 NW 57TH AVE
Practice Address - Street 2:STE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2041
Practice Address - Country:US
Practice Address - Phone:305-267-1515
Practice Address - Fax:305-266-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20898096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20898096Medicare ID - Type Unspecified