Provider Demographics
NPI:1558450643
Name:PALM BEACH HOME HEALTH INC
Entity Type:Organization
Organization Name:PALM BEACH HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-963-5544
Mailing Address - Street 1:201 OHIO RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-4821
Mailing Address - Country:US
Mailing Address - Phone:561-963-5544
Mailing Address - Fax:561-963-1883
Practice Address - Street 1:2150 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:W PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-4821
Practice Address - Country:US
Practice Address - Phone:561-963-5544
Practice Address - Fax:561-963-1883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108182Medicare Oscar/Certification