Mis Abuelos Home Care Corp.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

AL11421 Issued in FL

Legal business name

MIS ABUELOS HOME CARE CORP.

Practice address

8422 Woodlake Dr
Tampa, FL 33615-1717

Phone

(813) 784-0328

Fax

(813) 886-1430

NPI assigned

Jan 23, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Dagoberto Medina

Title

Owner

Phone

(813) 784-0328

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mis Abuelos Home Care Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mis Abuelos Home Care Corp.

  • Assisted Living Facility
  • Tampa, FL
  • NPI 1326368960
  NPD tax ID

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1689097982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 WOODLAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336151717",
            "telephone_number": "813-784-0328",
            "fax_number": "813-886-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8422 WOODLAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336151717",
            "telephone_number": "813-784-0328",
            "fax_number": "813-886-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIS ABUELOS HOME CARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "DAGOBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-784-0328",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": "AL11421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE",
            "identifier": "AL11421",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph A Mirville Jr., PA-C
• Abu-Sayeef Mirza, MD MPH
• Nausheen Mirza, DDS
• Rubina Shaheen Mirza
• Mis Abuelos Home Care Corp.
• Karen Mischka, CRNA
• Allison Miscik, MD
• Jonathan Misdea, CRNA
• Kelly Ruth Mish
• Asmita Mishra, M.D.

• Adult Day Care Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.