Provider Demographics
NPI:1649564030
Name:MAYON HEALTHCARE& STAFFING SERVICES
Entity Type:Organization
Organization Name:MAYON HEALTHCARE& STAFFING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:UCHENNA
Authorized Official - Last Name:ONOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-699-4020
Mailing Address - Street 1:18350 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4519
Mailing Address - Country:US
Mailing Address - Phone:305-974-4294
Mailing Address - Fax:305-974-4647
Practice Address - Street 1:18350 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4519
Practice Address - Country:US
Practice Address - Phone:305-974-4294
Practice Address - Fax:305-974-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211502251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health