Provider Demographics
NPI:1447258769
Name:HOME HEALTH SERVICES OF SOUTH FLORIDA, INC
Entity type:Organization
Organization Name:HOME HEALTH SERVICES OF SOUTH FLORIDA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-735-7332
Mailing Address - Street 1:4101 NW 4TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2839
Mailing Address - Country:US
Mailing Address - Phone:954-735-7332
Mailing Address - Fax:954-731-0110
Practice Address - Street 1:4101 NW 4TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2839
Practice Address - Country:US
Practice Address - Phone:954-735-7332
Practice Address - Fax:954-731-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21223096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
107397Medicare ID - Type Unspecified