NPIMap

Organization Active NPI

Angels for Kids on Call 24/7 Inc.

  • Community/Behavioral Health Agency
  • Palm Bay, FL
National Provider Identifier
1629483706
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ANGELS FOR KIDS ON CALL 24/7 INC.
Practice address
1071 Port Malabar Blvd NE Ste 106
Palm Bay, FL 32905-5161
Phone
(321) 373-8801
Fax
(407) 985-3678
NPI assigned
Jun 26, 2014
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
John Valencia
Title
Billing
Phone
(407) 730-7983

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X FL Primary

Addresses

Primary practice location

1071 Port Malabar Blvd NE Ste 106
Palm Bay, FL 32905-5161

Mailing address

1071 Port Malabar Blvd NE Ste 106
Palm Bay, FL 32905-5161
Phone (407) 730-7983

Other practice location 1

19 N 6th St Ste 19A
Haines City, FL 33844-4205
Phone (863) 216-6595

Other practice location 2

3201 E Colonial Dr Ste D46
Orlando, FL 32803-5140
Phone (407) 730-7983

Other identifiers 1

IdentifierTypeStateIssuer
012331300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220202001012 FL Part B Supplier - Clinic/Group Practice 0941639488 Receives reassigned benefits from 4 practitioners
Practice locations: Haines City, FL; Palm Bay, FL; Orlando, FL

National Provider Directory

National Provider Directory
Tax ID family
Angels for Kids on Call 2477 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3201 E Colonial Dr
Ste D46
Orlando, FL 32803

3463 E Colonial Dr
#G2
Orlando, FL 32803

518 Peachtree Rd
Orlando, FL 32804
Phone (407) 449-6575

Practitioners & affiliated clinicians

Practitioners 4

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": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1629483706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE STE 106",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "407-730-7983",
            "fax_number": "407-985-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE STE 106",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "321-373-8801",
            "fax_number": "407-985-3678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 N 6th St Ste 19A",
            "address_purpose": "LOCATION",
            "city": "Haines City",
            "state": "FL",
            "postal_code": "338444205",
            "country_code": "US",
            "telephone_number": "863-216-6595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 E Colonial Dr Ste D46",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328035140",
            "country_code": "US",
            "telephone_number": "407-730-7983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANGELS FOR KIDS ON CALL 24/7 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "VALENCIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "407-730-7983"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012331300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.