NPIMap

Organization Active NPI

Divine Angels Services

  • In Home Supportive Care Agency
  • Miami, FL
National Provider Identifier
1790113306
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
230135 Issued in FL
Legal business name
DIVINE ANGELS SERVICES
Practice address
10300 SW 72ND Street
Suite 460-7
Miami, FL 33173-1828
Phone
(786) 316-5224
Fax
(305) 275-1828
NPI assigned
Oct 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Dominica CamposNPI 1831527282
Title
President
Phone
(786) 316-5224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 230135 FL Primary

Addresses

Primary practice location

10300 SW 72ND Street
Suite 460-7
Miami, FL 33173-1828

Mailing address

10300 SW 72ND Street
Suite 460-7
Miami, FL 33173-1828
Phone (786) 316-5224

Other identifiers 2

IdentifierTypeStateIssuer
000287901MedicaidFL
000287900OtherFLDEVELOPMENTAL DISABILITIES HOME AND COMMUNITY-BASED WAIVER SERVICES

National Provider Directory

National Provider Directory
Tax ID family
Divine Angel Services Inc2 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.

Locations

10300 SW 72nd St
Ste 460-7
Miami, FL 33173
Phone (786) 316-5224

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1790113306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND STREET",
            "address_2": "SUITE 460-7",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731828",
            "telephone_number": "786-316-5224",
            "fax_number": "305-392-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND STREET",
            "address_2": "SUITE 460-7",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731828",
            "telephone_number": "786-316-5224",
            "fax_number": "305-275-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE ANGELS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-316-5224"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "230135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000287901",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEVELOPMENTAL DISABILITIES HOME AND COMMUNITY-BASED WAIVER SERVICES",
            "identifier": "000287900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 28, 2015; 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.