Provider Demographics
NPI:1982701165
Name:SANTA FE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SANTA FE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:DIAZ MONTESINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-262-8845
Mailing Address - Street 1:7280 NW 7TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2951
Mailing Address - Country:US
Mailing Address - Phone:305-262-8845
Mailing Address - Fax:305-262-8825
Practice Address - Street 1:7280 NW 7TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2951
Practice Address - Country:US
Practice Address - Phone:305-262-8845
Practice Address - Fax:305-262-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299992135251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651247000Medicaid
FL651247000Medicaid