Active NPI
Hybrid Healthcare Staffing Agency. LLC
- Community Based Hospice Care Agency
- Miami, FL
National Provider Identifier
1306131107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- AHCA # 30211162
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30211162 | Other | FL | STATE OF FLORIDA AHCA LICENSE NUMBER |
National Provider Directory
National Provider DirectoryLocations
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.