Organization Active NPI

Elite Infusion Services LLC

  • Home Health Agency
  • West Palm Beach, FL
National Provider Identifier
1972195279
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELITE INFUSION SERVICES LLC
Practice address
560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945
Phone
(561) 766-0612
NPI assigned
Feb 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Mr. Angel Antonio Abrego, LPN
Title
Owner
Phone
(561) 766-0612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945

Mailing address

560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945
Phone (561) 766-0612

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214002854 FL Part A Provider - Home Health Agency 3375912397 Practice locations: West Palm Beach, FL

Home health agency certification: CCN 687282

Legal name
ELITE INFUSION SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 11, 2023
Last certification
Sep 11, 2023
Organization structure
LLCProprietary
Incorporated
Nov 20, 2020 in FL
Enrollment address
560 Village Blvd
# 325A
West Palm Beach, FL 33409-1945
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Infusion Services LLCCCN 687282
Overall star rating
3 of 5
Ownership
-
Certified
Sep 11, 2023
Medicare certification status
ActiveFrom the Provider of Services file

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
10D2251058Elite Infusion Services LLC560 Village Blvd 325a, West Palm Beach, FL 33409Certificate of waiverJan 31, 2028

National Provider Directory

National Provider Directory

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
Angel Abrego Individual 5% Or Greater Direct Ownership Interest Aug 24, 2020 50%
Corporate Director Aug 24, 2020 50%
W-2 Managing Employee Aug 24, 2020 50%
Daine Guevara Individual 5% Or Greater Direct Ownership Interest Aug 24, 2020 50%
Corporate Director Aug 24, 2020 50%
W-2 Managing Employee Aug 24, 2020 50%

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1972195279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VILLAGE BLVD STE 325A",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091945",
            "telephone_number": "561-766-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 VILLAGE BLVD STE 325A",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091945",
            "telephone_number": "561-766-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE INFUSION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "ABREGO",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-766-0612",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.