Organization
PRIME VIDA HOME SUPPORT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE E FERNANDEZ CALANA (OWNER)
(305) 924-3220
Entity
Organization
Contact information
Practice address
3912 W 12TH AVE, HIALEAH, FL 33012-4105
(754) 345-7001
Mailing address
3912 W 12TH AVE, HIALEAH, FL 33012-4105
(754) 345-7001
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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