Provider Demographics
NPI:1427927169
Name:LEGACY HEALTH CARE LLC
Entity type:Organization
Organization Name:LEGACY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISSET
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIAN ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:ISW
Authorized Official - Phone:786-378-1948
Mailing Address - Street 1:2300 W 84TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5771
Mailing Address - Country:US
Mailing Address - Phone:305-530-8298
Mailing Address - Fax:305-530-8466
Practice Address - Street 1:2300 W 84TH ST STE 111
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5771
Practice Address - Country:US
Practice Address - Phone:305-530-8298
Practice Address - Fax:305-530-8466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty