Provider Demographics
NPI:1902019144
Name:HARTFORD HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:HARTFORD HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:HELENE
Authorized Official - Last Name:PALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-445-3377
Mailing Address - Street 1:13200 SW 128TH STREET
Mailing Address - Street 2:SUITE G1
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1935
Mailing Address - Country:US
Mailing Address - Phone:305-445-3377
Mailing Address - Fax:305-445-2277
Practice Address - Street 1:13200 SW 128TH STREET
Practice Address - Street 2:SUITE G1
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1935
Practice Address - Country:US
Practice Address - Phone:305-445-3377
Practice Address - Fax:305-445-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992693251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651569000Medicaid
FL299992693OtherAHCA HOME HEALTH LICENSE
FL651569000Medicaid