Provider Demographics
NPI:1649414376
Name:LIFESPAN HOME HEALTH CARE OF MIAMI, LLC
Entity Type:Organization
Organization Name:LIFESPAN HOME HEALTH CARE OF MIAMI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CAO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-321-0700
Mailing Address - Street 1:777 NW 72ND AVE
Mailing Address - Street 2:SUITE 3008
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3009
Mailing Address - Country:US
Mailing Address - Phone:305-321-0700
Mailing Address - Fax:305-893-6771
Practice Address - Street 1:777 NW 72ND AVE
Practice Address - Street 2:SUITE 3008
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3009
Practice Address - Country:US
Practice Address - Phone:305-321-0700
Practice Address - Fax:305-893-6771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESPAN GROUP INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health