Provider Demographics
NPI:1295293868
Name:OMNI OTHERS LLC
Entity type:Organization
Organization Name:OMNI OTHERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:COELHO DE ANDRADE XAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-961-4954
Mailing Address - Street 1:8177 GLADES RD STE 220
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4022
Mailing Address - Country:US
Mailing Address - Phone:561-961-4954
Mailing Address - Fax:561-922-3342
Practice Address - Street 1:8177 GLADES RD STE 220
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4022
Practice Address - Country:US
Practice Address - Phone:561-961-4954
Practice Address - Fax:561-922-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-03
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health