Provider Demographics
NPI:1811143118
Name:AT HOME CARE NURSING LLC
Entity type:Organization
Organization Name:AT HOME CARE NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZABET
Authorized Official - Middle Name:
Authorized Official - Last Name:AZZARETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-709-3593
Mailing Address - Street 1:6902 SW 83RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2522
Mailing Address - Country:US
Mailing Address - Phone:786-709-3593
Mailing Address - Fax:305-279-3192
Practice Address - Street 1:1150 NW 72ND AVE STE 460
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1947
Practice Address - Country:US
Practice Address - Phone:305-477-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19966217251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health