Provider Demographics
NPI:1568544021
Name:MAYA HOME HEALTH CARE CORP.
Entity Type:Organization
Organization Name:MAYA HOME HEALTH CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-556-3664
Mailing Address - Street 1:126 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1853
Mailing Address - Country:US
Mailing Address - Phone:305-556-3664
Mailing Address - Fax:305-556-3644
Practice Address - Street 1:126 E 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1853
Practice Address - Country:US
Practice Address - Phone:305-556-3664
Practice Address - Fax:305-556-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10-8347251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651264000Medicaid
FL651264000Medicaid