Provider Demographics
NPI:1871644328
Name:MYG HOME CARE AGENCY INC.
Entity Type:Organization
Organization Name:MYG HOME CARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:CABEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-227-3664
Mailing Address - Street 1:11398 W FLAGLER ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-4213
Mailing Address - Country:US
Mailing Address - Phone:305-227-3664
Mailing Address - Fax:305-227-8464
Practice Address - Street 1:11398 W FLAGLER ST
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-4213
Practice Address - Country:US
Practice Address - Phone:305-227-3664
Practice Address - Fax:305-227-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20665096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107706Medicare ID - Type UnspecifiedMEDICARE PROVIDER