Provider Demographics
NPI:1629214416
Name:PRO HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:PRO HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-450-8846
Mailing Address - Street 1:5881 NW 151ST ST STE 207
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2456
Mailing Address - Country:US
Mailing Address - Phone:305-819-0660
Mailing Address - Fax:305-819-0661
Practice Address - Street 1:5881 NW 151ST ST STE 207
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-2456
Practice Address - Country:US
Practice Address - Phone:305-819-0660
Practice Address - Fax:305-819-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-28
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992648251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health