Provider Demographics
NPI:1427041128
Name:P/S HOME HEALTH CARE
Entity type:Organization
Organization Name:P/S HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-0669
Mailing Address - Street 1:1779 W 37TH ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4671
Mailing Address - Country:US
Mailing Address - Phone:305-557-0669
Mailing Address - Fax:305-557-0845
Practice Address - Street 1:1779 W 37TH ST
Practice Address - Street 2:SUITE 15
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4671
Practice Address - Country:US
Practice Address - Phone:305-557-0669
Practice Address - Fax:305-557-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL843332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0760010001Medicare ID - Type Unspecified