Provider Demographics
NPI:1992054506
Name:AXIS HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:AXIS HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:305-824-8802
Mailing Address - Street 1:27501 S. DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032
Mailing Address - Country:US
Mailing Address - Phone:305-824-8802
Mailing Address - Fax:305-824-8803
Practice Address - Street 1:44 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3211
Practice Address - Country:US
Practice Address - Phone:305-824-8802
Practice Address - Fax:305-824-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994087251E00000X
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health