Provider Demographics
NPI:1841457132
Name:PERCEPTION CARE SERVICES CORP.
Entity type:Organization
Organization Name:PERCEPTION CARE SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:HERNANDEZ
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:813-315-9831
Mailing Address - Street 1:211 S MOON AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5703
Mailing Address - Country:US
Mailing Address - Phone:813-315-9831
Mailing Address - Fax:813-315-9833
Practice Address - Street 1:211 S MOON AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5703
Practice Address - Country:US
Practice Address - Phone:813-315-9831
Practice Address - Fax:813-315-9833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL986251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health