Mahanaim Home Care L.L.C.

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

MAHANAIM HOME CARE L.L.C.

Practice address

2750 N 29TH Ave Ste 218B
Hollywood, FL 33020-1521

Phone

(954) 270-0563

NPI assigned

Oct 19, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Myriam Frazil, R.N.

Title

President/Ceo

Phone

(954) 270-0562

Specialties & licenses 1

Addresses

Listed as

Mahanaim Home Care LLCCCN 687255

Ownership

-

Certified

Apr 21, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1508465725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 N 29 AVENUE SUITE 218B",
            "city": "HOLLYWOOD FL",
            "state": "FL",
            "postal_code": "330203982",
            "telephone_number": "954-270-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 N 29TH AVE STE 218B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201521",
            "telephone_number": "954-270-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHANAIM HOME CARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "FRAZIL",
        "authorized_official_first_name": "MYRIAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "954-270-0562",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Home Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.