Organization Active NPI

Hybrid Healthcare Staffing Agency. LLC

  • Community Based Hospice Care Agency
  • Miami, FL
National Provider Identifier
1306131107
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
AHCA # 30211162 Issued in FL
Legal business name
HYBRID HEALTHCARE STAFFING AGENCY. LLC
Practice address
4995 NW 72ND Ave Ste 307
Miami, FL 33166-5643
Phone
(305) 477-7811
Fax
(305) 593-8225
NPI assigned
Jun 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Authorized official

Name
Mrs. Adetutu Ajagbe, MBA
Title
Administrator
Phone
(305) 477-7811

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AHCA # 30211162 FL
Community Based Hospice Care Agency 251G00000X AHCA # 30211162 FL Primary
Nursing Care Agency 251J00000X AHCA # 30211162 FL
In Home Supportive Care Agency 253Z00000X AHCA # 30211162 FL

Addresses

Primary practice location

4995 NW 72ND Ave Ste 307
Miami, FL 33166-5643

Mailing address

4995 NW 72ND Ave Ste 307
Miami, FL 33166-5643
Phone (305) 477-7811

Other identifiers 1

IdentifierTypeStateIssuer
30211162OtherFLSTATE OF FLORIDA AHCA LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

4995 NW 72nd Ave
Ste 307
Miami, FL 33166
Phone (305) 477-7811

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1306131107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE STE 307",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "305-477-7811",
            "fax_number": "305-593-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE STE 307",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "305-477-7811",
            "fax_number": "305-593-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYBRID HEALTHCARE STAFFING AGENCY. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "AJAGBE",
        "authorized_official_first_name": "ADETUTU",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-477-7811",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "AHCA # 30211162",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "AHCA # 30211162",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "AHCA # 30211162",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "AHCA # 30211162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA  AHCA LICENSE NUMBER",
            "identifier": "30211162",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.