Provider Demographics
NPI:1679449714
Name:ST JUDE HOME HEALTH CARE CORP
Entity type:Organization
Organization Name:ST JUDE HOME HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDRAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-256-1505
Mailing Address - Street 1:955 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3206
Mailing Address - Country:US
Mailing Address - Phone:305-256-1505
Mailing Address - Fax:305-256-1482
Practice Address - Street 1:955 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3206
Practice Address - Country:US
Practice Address - Phone:305-256-1505
Practice Address - Fax:305-256-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health