Provider Demographics
NPI:1790959062
Name:PUENTES DE HADAS HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PUENTES DE HADAS HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-824-9011
Mailing Address - Street 1:1800 W 49TH ST
Mailing Address - Street 2:SUITE 324 S
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2900
Mailing Address - Country:US
Mailing Address - Phone:305-824-9011
Mailing Address - Fax:305-824-9013
Practice Address - Street 1:1800 W 49TH ST
Practice Address - Street 2:SUITE 324 S
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2900
Practice Address - Country:US
Practice Address - Phone:305-824-9011
Practice Address - Fax:305-824-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDING MEDICARE#OtherPENDING MEDICARE#