Provider Demographics
NPI:1831397009
Name:ISA ADULT HOME CARE INC
Entity type:Organization
Organization Name:ISA ADULT HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILEYDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-257-9545
Mailing Address - Street 1:4363 SW 146 AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-392-0354
Mailing Address - Fax:786-485-3030
Practice Address - Street 1:4363 SW 146 AVE.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-392-0354
Practice Address - Fax:786-485-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9623310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141985400Medicaid