Organization Active NPI

Flor de la Fe Home Health LLC

  • Home Health Agency
  • Brownsville, TX
National Provider Identifier
1487255394
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FLOR DE LA FE HOME HEALTH LLC
Practice address
4804 Beaver Pond Dr
Brownsville, TX 78520-9225
Phone
(956) 466-8862
NPI assigned
Nov 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Jose A Medina
Title
Owner
Phone
(956) 466-8862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4804 Beaver Pond Dr
Brownsville, TX 78520-9225

Mailing address

4804 Beaver Pond Dr
Brownsville, TX 78520-9225
Phone (956) 466-8862

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323000182 TX Part A Provider - Home Health Agency 8729495593 Practice locations: Brownsville, TX

Home health agency certification: CCN 748010

Legal name
FLOR DE LA FE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 17, 2021
Last certification
May 17, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 14, 2020 in TX
Enrollment address
4804 Beaver Pond Dr
Brownsville, TX 78520-9225
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Flor de la Fe Home Health LLCCCN 748010
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
May 17, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy

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
45D2202993Flor de la Fe Home Health LLC4804 Beaver Pond Drive, Brownsville, TX 78520Certificate of waiverDec 1, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jose Angel Medina Individual 5% Or Greater Direct Ownership Interest Sep 14, 2020 100%
Corporate DirectorPresident/Secretary Sep 14, 2020
Josephina Medina Individual Corporate DirectorVice President Sep 14, 2020
W-2 Managing EmployeeAdministrator / Adon Sep 15, 2020
Corina Medina Individual W-2 Managing EmployeeDon Sep 15, 2020
Noelia Maldonado Individual W-2 Managing EmployeeAlternate Administrator Sep 15, 2020

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1487255394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 BEAVER POND DR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209225",
            "telephone_number": "956-466-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 BEAVER POND DR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209225",
            "telephone_number": "956-466-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOR DE LA FE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-466-8862"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.