Provider Demographics
NPI:1558664763
Name:HEAVENLY HOME CARE OF FLORIDA
Entity Type:Organization
Organization Name:HEAVENLY HOME CARE OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAMELIA RAMNARINE
Authorized Official - Middle Name:INDIRA
Authorized Official - Last Name:RAMNARINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-256-5435
Mailing Address - Street 1:17321 SW 109TH AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:786-256-5435
Mailing Address - Fax:
Practice Address - Street 1:17321 SW 109TH AVE.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:786-256-5435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10738310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility