Provider Demographics
NPI:1982912424
Name:NORTH MIAMI HEALTH SERVICE CORPORATION
Entity Type:Organization
Organization Name:NORTH MIAMI HEALTH SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:786-970-2680
Mailing Address - Street 1:6001 NW 153RD ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2419
Mailing Address - Country:US
Mailing Address - Phone:786-970-2680
Mailing Address - Fax:877-815-8592
Practice Address - Street 1:6001 NW 153RD ST
Practice Address - Street 2:SUITE G
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2419
Practice Address - Country:US
Practice Address - Phone:786-970-2680
Practice Address - Fax:877-815-8592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231093251C00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001335400Medicaid