Provider Demographics
NPI:1245655836
Name:MIZNER HOMECARE LLC
Entity type:Organization
Organization Name:MIZNER HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-526-5516
Mailing Address - Street 1:102 NE 2ND ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 SE MIZNER BLVD
Practice Address - Street 2:SUITE 213A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5008
Practice Address - Country:US
Practice Address - Phone:800-219-4304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health