Provider Demographics
NPI:1982385662
Name:HOME CARE ON TIME INC
Entity Type:Organization
Organization Name:HOME CARE ON TIME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-812-6861
Mailing Address - Street 1:2300 W 84TH ST STE 402A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5773
Mailing Address - Country:US
Mailing Address - Phone:786-953-7747
Mailing Address - Fax:786-953-7779
Practice Address - Street 1:9050 PINES BLVD STE 366
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6443
Practice Address - Country:US
Practice Address - Phone:786-953-7747
Practice Address - Fax:786-953-7779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE ON TIME INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105166200Medicaid