Provider Demographics
NPI:1518923390
Name:NANY HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:NANY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:F
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-387-3533
Mailing Address - Street 1:13155 SW 134TH ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4486
Mailing Address - Country:US
Mailing Address - Phone:305-969-4441
Mailing Address - Fax:305-969-4451
Practice Address - Street 1:13155 SW 134TH ST
Practice Address - Street 2:SUITE 118
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4486
Practice Address - Country:US
Practice Address - Phone:305-969-4441
Practice Address - Fax:305-969-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21869096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650945200Medicaid
FL022224100Medicaid
FL1242240001Medicare NSC
FL650945200Medicaid