Provider Demographics
NPI:1952892754
Name:MIDWAY HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:MIDWAY HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOMBINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-207-2775
Mailing Address - Street 1:7001 SW 97TH AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1407
Mailing Address - Country:US
Mailing Address - Phone:786-207-2775
Mailing Address - Fax:786-999-8397
Practice Address - Street 1:7001 SW 97TH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1407
Practice Address - Country:US
Practice Address - Phone:786-207-2775
Practice Address - Fax:786-999-8397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care