Organization Active NPI

Miracleo of Love, Inc.

  • Case Management Agency
  • Orlando, FL
National Provider Identifier
1447783956
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MIRACLEO OF LOVE, INC.
Practice address
741 W Colonial Dr
Orlando, FL 32804-7343
Phone
(407) 843-1760
Fax
(407) 843-1767
NPI assigned
Apr 11, 2017
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Mr. Angus Bradshaw Jr.
Title
Executive Director
Phone
(407) 843-1760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

741 W Colonial Dr
Orlando, FL 32804-7343

Mailing address

741 W Colonial Dr
Orlando, FL 32804-7343
Phone (407) 843-1760

Other identifiers 1

IdentifierTypeStateIssuer
FL9220132MedicaidFL

National Provider Directory

National Provider Directory

Locations

741 W Colonial Dr
Orlando, FL 32804
Phone (407) 843-1760

Practitioners & affiliated clinicians

Practitioners 2

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": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1447783956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328047343",
            "telephone_number": "407-843-1760",
            "fax_number": "407-843-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328047343",
            "telephone_number": "407-843-1760",
            "fax_number": "407-843-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLEO OF LOVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "ANGUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-843-1760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FL9220132",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.