Provider Demographics
NPI:1740310341
Name:I & S HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:I & S HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-551-2901
Mailing Address - Street 1:11180 W FLAGLER ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1216
Mailing Address - Country:US
Mailing Address - Phone:305-551-2901
Mailing Address - Fax:305-551-2902
Practice Address - Street 1:11180 W FLAGLER ST
Practice Address - Street 2:SUITE 15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1216
Practice Address - Country:US
Practice Address - Phone:305-551-2901
Practice Address - Fax:305-551-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FL299992653251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109079OtherMEDICARE PTAN
FL113729000Medicaid