Organization
BLUE DOOR HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMIL ALCOBA (ADMINISTRATOR)
(786) 842-0161
Entity
Organization
Contact information
Practice address
12150 SW 128TH CT STE 107, MIAMI, FL 33186-4648
(786) 842-0161
(786) 842-0335
Mailing address
12150 SW 128TH CT STE 107, MIAMI, FL 33186-4648
(786) 842-0161
(786) 842-0335
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30212054
LICENSE #
FL
Enumeration date
08/08/2019
Last updated
09/29/2020
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