Provider Demographics
NPI:1861633554
Name:BERRY SPECIAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:BERRY SPECIAL HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-275-2441
Mailing Address - Street 1:10300 SW 72 STREET SUITE 470H
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3003
Mailing Address - Country:US
Mailing Address - Phone:305-275-2441
Mailing Address - Fax:305-275-2442
Practice Address - Street 1:10300 SW 72 STREET SUITE 470H
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3003
Practice Address - Country:US
Practice Address - Phone:305-275-2441
Practice Address - Fax:305-275-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL299993461251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HHA 299993461OtherLICENCE NUMBER