Organization Active NPI

Mis Abuelos Home Care Corp.

  • Assisted Living Facility
  • Tampa, FL
National Provider Identifier
1326368960
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11421 Issued in FL
Legal business name
MIS ABUELOS HOME CARE CORP.
Practice address
8422 Woodlake Dr
Tampa, FL 33615-1717
Phone
(813) 886-1380
Fax
(813) 886-1430
NPI assigned
Jun 6, 2010
Last updated
Aug 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Mr. Dagoberto Medina
Title
Vicepresident
Phone
(813) 784-0328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11421 FL Primary

Addresses

Primary practice location

8422 Woodlake Dr
Tampa, FL 33615-1717

Mailing address

8422 Woodlake Dr
Tampa, FL 33615-1717
Phone (813) 886-1380

Other identifiers 1

IdentifierTypeStateIssuer
11421OtherFLASSISTED LIVING FACILITY AHCA LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Mis Abuelos Home Care Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1326368960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 WOODLAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336151717",
            "telephone_number": "813-886-1380",
            "fax_number": "813-886-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8422 WOODLAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336151717",
            "telephone_number": "813-886-1380",
            "fax_number": "813-886-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIS ABUELOS HOME CARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-06",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "DAGOBERTO",
        "authorized_official_title_or_position": "VICEPRESIDENT",
        "authorized_official_telephone_number": "813-784-0328",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTED LIVING FACILITY AHCA LICENSE",
            "identifier": "11421",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.