Provider Demographics
NPI:1396590378
Name:MEDELLA HOME HEALTH LLC
Entity type:Organization
Organization Name:MEDELLA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MILEIDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROQUE PUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-443-2555
Mailing Address - Street 1:15800 PINES BLVD STE 341
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1212
Mailing Address - Country:US
Mailing Address - Phone:954-569-8698
Mailing Address - Fax:954-569-8699
Practice Address - Street 1:15800 PINES BLVD STE 341
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1212
Practice Address - Country:US
Practice Address - Phone:954-569-8698
Practice Address - Fax:954-569-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health