Provider Demographics
NPI:1356513097
Name:PLATINUM CARE HOME SERVICES INC.
Entity type:Organization
Organization Name:PLATINUM CARE HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-715-9745
Mailing Address - Street 1:7500 NW 25TH ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1713
Mailing Address - Country:US
Mailing Address - Phone:305-715-9745
Mailing Address - Fax:305-715-9940
Practice Address - Street 1:7500 NW 25TH ST
Practice Address - Street 2:SUITE 245
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1713
Practice Address - Country:US
Practice Address - Phone:305-715-9745
Practice Address - Fax:305-715-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992434251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299992434OtherAHCA