Provider Demographics
NPI:1538710652
Name:SOMY CARE SERVICE CORP
Entity type:Organization
Organization Name:SOMY CARE SERVICE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-623-9622
Mailing Address - Street 1:11941 SW 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5135
Mailing Address - Country:US
Mailing Address - Phone:786-623-9622
Mailing Address - Fax:130-567-5598
Practice Address - Street 1:11980 SW 144TH CT STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8603
Practice Address - Country:US
Practice Address - Phone:786-623-9622
Practice Address - Fax:305-675-5987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No385HR2050XRespite Care FacilityRespite CareRespite Care CampGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690851996Medicaid