Organization Active NPI

Jazmin Serra

Doing business as Amazing Companions

  • Home Health Agency
  • Lake Mary, FL
National Provider Identifier
1376963561
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JAZMIN SERRA
Doing business as
Amazing Companions
Practice address
160 International Pkwy Ste 100
Lake Mary, FL 32746-5057
Phone
(321) 775-5685
Fax
(407) 386-3056
NPI assigned
Apr 26, 2014
Organization subpart
Yes
Parent organization
AMAZING COMPANIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Dr. Jazmin Serra, PHD
Title
Administrator
Phone
(321) 775-5685

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X 233395 FL
Developmental Disabilities Clinic/Center 261QD1600X 233395 FL

Addresses

Primary practice location

160 International Pkwy Ste 100
Lake Mary, FL 32746-5057

Mailing address

160 International Pkwy Ste 100
Lake Mary, FL 32746-5057
Phone (321) 775-5685

Other identifiers 1

IdentifierTypeStateIssuer
022390100MedicaidFL

Other names 1

  • Amazing Companions Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jazmin Serra2 organizations share this tax ID, including this one
Part of
Jazmin Serra

Other organizations with this tax ID 1

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

Locations

160 International Pkwy
Ste 100
Lake Mary, FL 32746
Phone (321) 775-5685

NPI Registry JSON

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

{
    "created_epoch": "1398470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1376963561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 INTERNATIONAL PKWY STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465057",
            "telephone_number": "321-775-5685",
            "fax_number": "407-650-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 INTERNATIONAL PKWY STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465057",
            "telephone_number": "321-775-5685",
            "fax_number": "407-386-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAZMIN SERRA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMAZING COMPANIONS",
        "enumeration_date": "2014-04-26",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "SERRA",
        "authorized_official_first_name": "JAZMIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-775-5685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "233395",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "233395",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022390100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amazing Companions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.