Organization
ANTAEUS HEALTH SERVICES, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCOS RETA (ADMINISTRATOR & OWNER)
(305) 500-9697
Entity
Organization
Contact information
Practice address
7333 CORAL WAY, SUITE 109, MIAMI, FL 33155-1402
(305) 500-9697
(305) 500-9994
Mailing address
7333 CORAL WAY, SUITE 109, MIAMI, FL 33155-1402
(305) 500-9697
(305) 500-9994
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA299991821
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-8058
PROVIDER NUMBER
FL
01
—
651030200
MEDICAID PROVIDER NUMBER
FL
01
—
HHA299991821
HOME HEALTH AGENCY
FL
Enumeration date
01/23/2007
Last updated
03/21/2012
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