NPIMap

Organization Active NPI

Little Havana Activities & Nutrition Centers of Dade County, Inc.

  • Home Health Agency
  • Miami, FL
National Provider Identifier
1366572810
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299991843 Issued in FL
Legal business name
LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE COUNTY, INC.
Practice address
700 SW 8TH Street
Miami, FL 33130
Phone
(305) 858-0887
Fax
(305) 285-7852
NPI assigned
Mar 6, 2007
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Mr. Rafael Iglesias, CPA
Title
President
Phone
(305) 858-0887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299991843 FL Primary

Addresses

Primary practice location

700 SW 8TH Street
Miami, FL 33130

Mailing address

700 SW 8TH Street
Miami, FL 33130
Phone (305) 858-0887

Other identifiers 1

IdentifierTypeStateIssuer
651068000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041117001161 FL Part A Provider - Home Health Agency 3476517533 Practice locations: Miami, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366572810. Details of each certification follow.

Home health agency certification: CCN 108205

Legal name
LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE COUNTY, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 26, 2005
Last certification
Sep 9, 2020
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Oct 6, 1973 in FL
Enrollment address
700 SW 8TH St
Miami, FL 33130-3311
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Little Havana Activites & Nutrition Centers of DadCCN 108205 · All quality measures
Ownership
Non-Profit
Certified
Sep 26, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory
Tax ID family
Little Havana Activities Nutrition Centers of Dade County Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

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
Manuel Marrero Individual Corporate Officer Jun 8, 1995
Corporate Director Nov 17, 2004
Rafael Iglesias Individual Corporate OfficerPres Jul 1, 2017
W-2 Managing EmployeePres Jul 1, 2017

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1366572810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SW 8TH STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33130",
            "telephone_number": "305-858-0887",
            "fax_number": "305-285-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW 8TH STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33130",
            "telephone_number": "305-858-0887",
            "fax_number": "305-285-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "IGLESIAS",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-858-0887",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299991843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651068000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.