NPIMap

Organization Active NPI

Divine Home Health Care, Inc

  • Home Health Agency
  • Tampa, FL
National Provider Identifier
1801066071
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIVINE HOME HEALTH CARE, INC
Practice address
6107 Memorial Hwy Ste B
Tampa, FL 33615-4564
Phone
(813) 890-3400
Fax
(813) 464-8069
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Gelys L Rios
Title
President
Phone
(813) 810-8650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

6107 Memorial Hwy Ste B
Tampa, FL 33615-4564

Mailing address

4534B W Village Dr
Tampa, FL 33624-3429

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000484 DC Part A Provider - Home Health Agency 1850467259 Practice locations: Tampa, FL

Home health agency certification: CCN 109361

Legal name
DIVINE HOME HEALTH CARE, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 10, 2009
Last certification
Apr 9, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 2, 2007 in FL
Enrollment address
6107 Memorial Hwy
Suite D
Tampa, FL 33615
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Divine Home Health Care IncCCN 109361
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Jun 10, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2034101Divine Home Health Care Inc6107 Memorial Hwy, Tampa, FL 33615Certificate of waiverDec 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Divine Home Health Care 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

5519 Hanley Rd
Ste B
Tampa, FL 33634
Phone (813) 890-3400

6107 Memorial Hwy
Ste D
Tampa, FL 33615
Phone (813) 890-3400

4534 W Village Dr
Ste B
Tampa, FL 33624
Phone (813) 333-6891

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gelys Gongora Individual 5% Or Greater Direct Ownership Interest Aug 1, 2008 50%
Julio Cordovi Individual 5% Or Greater Direct Ownership Interest Aug 1, 2008 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1801066071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534B W VILLAGE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336243429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154564",
            "telephone_number": "813-890-3400",
            "fax_number": "813-464-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOME HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "RIOS",
        "authorized_official_first_name": "GELYS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-810-8650"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.