Organization
THE WAKI AND SOL OF MIAMI CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY OUSTABASSIDIS (DIRECTOR)
(954) 864-3996
Entity
Organization
Contact information
Practice address
1031 IVES DAIRY RD STE 228, MIAMI, FL 33179-2538
(786) 420-5002
Mailing address
1031 IVES DAIRY RD STE 228, MIAMI, FL 33179-2538
(786) 712-4589
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
227342
FL
253Z00000X
In Home Supportive Care Agency
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105651200
—
FL
05
—
106470400
—
FL
05
—
1245573773
—
FL
Enumeration date
04/03/2013
Last updated
11/18/2022
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