Provider Demographics
NPI:1871755967
Name:PROFESSIONAL PLUS HOME HEALTH INC
Entity type:Organization
Organization Name:PROFESSIONAL PLUS HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-969-5741
Mailing Address - Street 1:2450 SW 137TH AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-969-5741
Mailing Address - Fax:305-969-8273
Practice Address - Street 1:2450 SW 137TH AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-969-5741
Practice Address - Fax:305-969-8273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021852300Medicaid