Provider Demographics
NPI:1700835949
Name:LUMARS HEALTH CARE CORP
Entity Type:Organization
Organization Name:LUMARS HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-482-0172
Mailing Address - Street 1:10887 NW 17TH ST UNIT 211
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2046
Mailing Address - Country:US
Mailing Address - Phone:305-482-0172
Mailing Address - Fax:305-482-0176
Practice Address - Street 1:10887 NW 17TH ST UNIT 211
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2046
Practice Address - Country:US
Practice Address - Phone:305-482-0172
Practice Address - Fax:305-482-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-06
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21842096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650970300Medicaid
FL650970300Medicaid