NPIMap

Organization Active NPI

Princess Home Health Agency Inc.

  • Home Health Agency
  • Hialeah, FL
National Provider Identifier
1932396520
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299992548 Issued in FL
Legal business name
PRINCESS HOME HEALTH AGENCY INC.
Practice address
535 E 25TH St
Hialeah, FL 33013-3812
Phone
(305) 693-3108
Fax
(305) 693-9825
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Elena Luz Rosello, RN
Title
Don
Phone
(305) 693-3108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299992548 FL Primary

Addresses

Primary practice location

535 E 25TH St
Hialeah, FL 33013-3812

Mailing address

535 E 25TH St
Hialeah, FL 33013-3812
Phone (305) 693-3108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080820000115 FL Part A Provider - Home Health Agency 8729153127 Practice locations: Miami, FL

Home health agency certification: CCN 109230

Legal name
PRINCESS HOME HEALTH AGENCY, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 14, 2009
Last certification
Mar 20, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 13, 2006 in FL
Enrollment address
175 Fontainebleau Blvd
Ste 2G3
Miami, FL 33172-7013

Care Compare: Home health agency

Medicare Care Compare
Listed as
Princess Home Health Agency IncCCN 109230
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Mar 14, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, 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
10D1061676Princess Home Health Agency175 Fontainebleau Blvd Ste 2G-3, Miami, FL 33172Certificate of waiverNov 26, 2026

National Provider Directory

National Provider Directory

Locations

535 E 25th St
Hialeah, FL 33013
Phone (305) 693-3108

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
Joel Rosello Individual 5% Or Greater Direct Ownership Interest Jul 30, 2013 50%
Corporate OfficerVice President Jul 30, 2013 50%
Corporate Director Jul 30, 2013
W-2 Managing EmployeeAdministrator Sep 7, 2011 100%
Operational/Managerial ControlAdministrator Sep 7, 2011 100%
Elena Rosello Individual 5% Or Greater Direct Ownership Interest Apr 13, 2006 50%
Corporate OfficerPresident May 2, 2007 50%
W-2 Managing EmployeePresident May 2, 2007 100%

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1932396520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133812",
            "telephone_number": "305-693-3108",
            "fax_number": "305-693-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133812",
            "telephone_number": "305-693-3108",
            "fax_number": "305-693-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCESS HOME HEALTH AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "ROSELLO",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "LUZ",
        "authorized_official_title_or_position": "DON",
        "authorized_official_telephone_number": "305-693-3108",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.