Provider Demographics
NPI:1487734612
Name:LESLY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:LESLY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:CODINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-553-7727
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD
Mailing Address - Street 2:#1R6
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172
Mailing Address - Country:US
Mailing Address - Phone:305-553-7727
Mailing Address - Fax:305-553-8522
Practice Address - Street 1:175 FONTAINEBLEAU BLVD
Practice Address - Street 2:#1R6
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172
Practice Address - Country:US
Practice Address - Phone:305-553-7727
Practice Address - Fax:305-553-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108207Medicare ID - Type Unspecified
FL108207Medicare Oscar/Certification