Provider Demographics
NPI:1912521980
Name:KING HOME HEALTH SERVICES CORP
Entity type:Organization
Organization Name:KING HOME HEALTH SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REGNAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEPPA HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-457-7339
Mailing Address - Street 1:16201 SW 95TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3459
Mailing Address - Country:US
Mailing Address - Phone:305-457-7339
Mailing Address - Fax:
Practice Address - Street 1:16201 SW 95TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3459
Practice Address - Country:US
Practice Address - Phone:305-457-7339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health