Organization Active NPI

Port Royal Home Health Care Inc

Doing business as Mandeville Quality Care

  • Home Health Agency
  • Miami, FL
National Provider Identifier
1417470659
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PORT ROYAL HOME HEALTH CARE INC
Doing business as
Mandeville Quality Care
Port Royal Transportation
Practice address
111 NW 183Rd St Ste 405
Miami, FL 33169-4619
Phone
(305) 337-1717
Fax
(786) 440-5046
NPI assigned
Jul 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Authorized official

Name
Kristo-Jay BaileyNPI 1093269409
Title
Ceo
Phone
(305) 337-1717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X
Non-emergency Medical Transport (VAN) 343900000X
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

111 NW 183Rd St Ste 405
Miami, FL 33169-4619

Mailing address

111 NW 183Rd St Ste 405
Miami, FL 33169-4619
Phone (305) 337-1717

Other identifiers 1

IdentifierTypeStateIssuer
111478500MedicaidFL

Other names 2

  • Mandeville Quality Care Doing business as
  • Port Royal Transportation Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2324953Port Royal Home Health Care Inc111 NW 183Rd Street Suite 318B, Miami, FL 33169Certificate of waiverJun 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1417470659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NW 183RD ST STE 405",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694619",
            "telephone_number": "305-337-1717",
            "fax_number": "786-440-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NW 183RD ST STE 405",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694619",
            "telephone_number": "305-337-1717",
            "fax_number": "786-440-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT ROYAL HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KRISTO-JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-337-1717"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111478500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mandeville Quality Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mandeville Quality Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Royal Transportation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.