Provider Demographics
NPI:1689612327
Name:MIAMI HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:MIAMI HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELISA
Authorized Official - Middle Name:CARIDAD
Authorized Official - Last Name:NOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-268-7823
Mailing Address - Street 1:7120 SW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4630
Mailing Address - Country:US
Mailing Address - Phone:786-268-7823
Mailing Address - Fax:786-268-7827
Practice Address - Street 1:7120 SW 47TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4630
Practice Address - Country:US
Practice Address - Phone:786-268-7823
Practice Address - Fax:786-268-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108190Medicare ID - Type UnspecifiedMEDICARE PROVIDER