Provider Demographics
NPI:1043482623
Name:MARCIALED HEALTHCARE CORP
Entity type:Organization
Organization Name:MARCIALED HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCIAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-355-7246
Mailing Address - Street 1:5209 NW 74TH AVE
Mailing Address - Street 2:SUITE#217
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4842
Mailing Address - Country:US
Mailing Address - Phone:305-994-7700
Mailing Address - Fax:305-994-7733
Practice Address - Street 1:5209 NW 74TH AVE
Practice Address - Street 2:SUITE#217
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4842
Practice Address - Country:US
Practice Address - Phone:305-994-7700
Practice Address - Fax:305-994-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993161251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health