Provider Demographics
NPI:1023124773
Name:FLORIDIAN HOME CARE AGENCY, INC.
Entity type:Organization
Organization Name:FLORIDIAN HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRULLENQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-864-9000
Mailing Address - Street 1:7098 BONITA DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3107
Mailing Address - Country:US
Mailing Address - Phone:305-864-9000
Mailing Address - Fax:305-864-3379
Practice Address - Street 1:7098 BONITA DR
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3107
Practice Address - Country:US
Practice Address - Phone:305-864-9000
Practice Address - Fax:305-864-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health