Individual provider Active NPI

Vadia Estevez

  • Developmentally Disabled Services Day Training Agency
  • Kissimmee, FL
National Provider Identifier
1487396792
Registry record updated Feb 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Practice address
1101 Miranda LN Ste 127
Kissimmee, FL 34741-0771
Phone
(321) 300-9077
Fax
(321) 291-5124
NPI assigned
Apr 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 113497700 FL
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

1101 Miranda LN Ste 127
Kissimmee, FL 34741-0771

Mailing address

1101 Miranda LN Ste 127
Kissimmee, FL 34741-0771
Phone (321) 300-9077

Other practice location 1

4606 Yellow Bay Dr
Kissimmee, FL 34758-2505
Phone (321) 300-9077

Other identifiers 1

IdentifierTypeStateIssuer
113497700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113497700FLMDDevelopmentally Disabled Services Day Training Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Evan Home Care Services CurrentSince May 14, 2023 Accepting new patients
Evan Home Care LLC CurrentSince Feb 18, 2024 Accepting new patients

Locations

1101 Miranda Ln
Ste 127
Kissimmee, FL 34741
Phone (321) 300-9077

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1487396792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MIRANDA LN STE 127",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410771",
            "telephone_number": "321-300-9077",
            "fax_number": "321-291-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MIRANDA LN STE 127",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410771",
            "telephone_number": "321-300-9077",
            "fax_number": "321-291-5124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4606 Yellow Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347582505",
            "country_code": "US",
            "telephone_number": "321-300-9077",
            "fax_number": "321-291-5124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTEVEZ",
        "first_name": "VADIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2024-02-17",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "113497700",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113497700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2024; 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.