Provider Demographics
NPI:1851398473
Name:ASA HOMECARE INC
Entity Type:Organization
Organization Name:ASA HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:A
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-229-1400
Mailing Address - Street 1:8700 W FLAGLER ST
Mailing Address - Street 2:STE-110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2428
Mailing Address - Country:US
Mailing Address - Phone:305-229-1400
Mailing Address - Fax:305-229-1828
Practice Address - Street 1:8700 W FLAGLER ST
Practice Address - Street 2:STE-110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2428
Practice Address - Country:US
Practice Address - Phone:305-229-1400
Practice Address - Fax:305-229-1828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107644Medicare ID - Type Unspecified