Provider Demographics
NPI:1568485241
Name:PROHEALTH NURSING SERVICES INC.
Entity Type:Organization
Organization Name:PROHEALTH NURSING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECELIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-433-2590
Mailing Address - Street 1:3268 S. UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025
Mailing Address - Country:US
Mailing Address - Phone:954-433-2590
Mailing Address - Fax:954-433-2641
Practice Address - Street 1:2231 N UNIVERSITY DR STE C
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3607
Practice Address - Country:US
Practice Address - Phone:954-433-2590
Practice Address - Fax:954-433-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991880251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108085Medicare ID - Type Unspecified