Organization
BLUE DOLPHIN HOME CARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO J ROMAN (OWNER)
(786) 447-3530
Entity
Organization
Contact information
Practice address
12855 SW 136TH AVE STE 218, MIAMI, FL 33186-5828
(786) 447-3530
(786) 221-4200
Mailing address
12855 SW 136TH AVE STE 218, MIAMI, FL 33186-5828
(786) 447-3530
(786) 221-4200
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30212866
AHCA
FL
Enumeration date
12/17/2024
Last updated
12/30/2024
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