Active NPI
Providence Healthcare Services, Inc.
- Home Health Agency
- Miami, FL
National Provider Identifier
1609456458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- PROVIDENCE HEALTHCARE SERVICES, INC.
- Practice address
- 10250 SW 56TH St Ste D103
Miami, FL 33165-7065 - Phone
- (305) 220-1088
- NPI assigned
- Apr 14, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nercy B Radcliffe
- Title
- Administrator
- Phone
- (305) 220-1088
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
10250 SW 56TH St Ste D103
Miami, FL 33165-7065
Mailing address
10250 SW 56TH St Ste D103
Miami, FL 33165-7065
Phone (305) 220-1088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 651696300 | Medicaid | FL |
Other names 1
- Providence Healthcare Services - Monroe
National Provider Directory
National Provider Directory- Tax ID family
- Providence Healthcare Services - Monroe
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Miami, FL
- NPI 1477748614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618358400000",
"number": "1609456458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10250 SW 56TH ST STE D103",
"city": "MIAMI",
"state": "FL",
"postal_code": "331657065",
"telephone_number": "305-220-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10250 SW 56TH ST STE D103",
"city": "MIAMI",
"state": "FL",
"postal_code": "331657065",
"telephone_number": "305-220-1088"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDENCE HEALTHCARE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-14",
"last_updated": "2021-04-14",
"certification_date": "2021-03-22",
"status": "A",
"authorized_official_last_name": "RADCLIFFE",
"authorized_official_first_name": "NERCY",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "305-220-1088"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "651696300",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Providence Healthcare Services - Monroe",
"code": "5",
"type": "Other Name"
}
]
}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 Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.