Provider Demographics
NPI:1578618062
Name:ALLEGIANCE HOME HEALTH AND REHAB
Entity Type:Organization
Organization Name:ALLEGIANCE HOME HEALTH AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:INGUANZO-MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-367-0711
Mailing Address - Street 1:551 NW 77TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1330
Mailing Address - Country:US
Mailing Address - Phone:561-367-0711
Mailing Address - Fax:561-367-0721
Practice Address - Street 1:551 NW 77TH ST STE 111
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1330
Practice Address - Country:US
Practice Address - Phone:561-367-0711
Practice Address - Fax:561-367-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992289251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108280Medicare UPIN