Provider Demographics
NPI:1447307491
Name:DEMOSTHENES HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:DEMOSTHENES HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMONSTHENES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-355-8882
Mailing Address - Street 1:17400 SW 97TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1800
Mailing Address - Country:US
Mailing Address - Phone:305-238-8725
Mailing Address - Fax:305-238-1058
Practice Address - Street 1:17400 SW 97TH AVW
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1800
Practice Address - Country:US
Practice Address - Phone:305-238-8725
Practice Address - Fax:305-238-1058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651078700Medicaid
FL651078700Medicaid