Provider Demographics
NPI:1912106923
Name:L.R. COMMSOJO AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:L.R. COMMSOJO AND ASSOCIATES, LLC
Other - Org Name:PROVIDENCE HOME HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CONRADO
Authorized Official - Middle Name:L
Authorized Official - Last Name:VALEROS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-749-2391
Mailing Address - Street 1:2968 MYRTLE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6737
Mailing Address - Country:US
Mailing Address - Phone:954-474-9040
Mailing Address - Fax:305-749-2392
Practice Address - Street 1:1031 IVES DAIRY RD
Practice Address - Street 2:SUITE 228
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:305-479-2391
Practice Address - Fax:305-749-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health