Provider Demographics
NPI:1255367751
Name:FLORIDA HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:FLORIDA HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-446-5276
Mailing Address - Street 1:1275 W 47TH PL STE 301
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3447
Mailing Address - Country:US
Mailing Address - Phone:305-446-5276
Mailing Address - Fax:305-446-5278
Practice Address - Street 1:1275 W 47TH PL STE 301
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3447
Practice Address - Country:US
Practice Address - Phone:305-446-5276
Practice Address - Fax:305-446-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA#299992211251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651454500Medicaid
FLHHA#299992211OtherAHCA
FL108382Medicare Oscar/Certification