NPIMap

Organization Active NPI

Marilu Home Health Care Inc.

  • Home Health Agency
  • Doral, FL
National Provider Identifier
1679757793
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299992926 Issued in FL
Legal business name
MARILU HOME HEALTH CARE INC.
Practice address
3785 NW 82ND Ave Ste 203
Doral, FL 33166
Phone
(305) 825-4677
Fax
(305) 825-4678
NPI assigned
Dec 26, 2007
Last updated
Jul 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Authorized official

Name
Mr. Huascar Pena
Title
President
Phone
(305) 825-4677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299992926 FL Primary

Addresses

Primary practice location

3785 NW 82ND Ave Ste 203
Doral, FL 33166

Mailing address

3785 NW 82ND Ave Ste 203
Doral, FL 33166-6630
Phone (305) 825-4677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000184 FL Part A Provider - Home Health Agency 0749351872 Practice locations: Doral, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679757793. Details of each certification follow.

Home health agency certification: CCN 109180

Legal name
MARILU HOME HEALTH CARE INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 11, 2009
Last certification
Jul 2, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 10, 2007 in FL
Enrollment address
3785 NW 82ND Ave
Suite 203
Doral, FL 33166-6633

Care Compare: Home health agency

Medicare Care Compare
Listed as
Marilu Home Health Care IncCCN 109180 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 11, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

3785 NW 82nd Ave
Ste 203
Doral, FL 33166
Phone (305) 825-4677

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Huascar Pena Individual 5% Or Greater Indirect Ownership Interest Oct 10, 2017 100%
Corporate OfficerPresident Oct 10, 2017 50%
Corporate DirectorPresident Oct 10, 2017 50%
W-2 Managing EmployeeAdministrator Oct 10, 2017 50%
Purity Home Health Services Inc Organization, Hialeah, FL Created for acquisition, Holding company 5% Or Greater Direct Ownership Interest Oct 10, 2017 100%

Practitioners & affiliated clinicians

Affiliated clinicians 17

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1679757793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 NW 82ND AVE STE 203",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666630",
            "telephone_number": "305-825-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 NW 82ND AVE STE 203",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "33166",
            "telephone_number": "305-825-4677",
            "fax_number": "305-825-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILU HOME HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "HUASCAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-825-4677",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.