Organization Active NPI

Apollo Advanced Home Health Corp.

  • Home Health Agency
  • Tampa, FL
National Provider Identifier
1972741254
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299993535 Issued in FL
Legal business name
APOLLO ADVANCED HOME HEALTH CORP.
Practice address
8910 N. Dale Mabry Hwy
Suite 16
Tampa, FL 33614
Phone
(813) 935-5555
Fax
(813) 933-6417
NPI assigned
Jan 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Authorized official

Name
Mr. Jose M Martinez
Title
Administrator
Phone
(813) 935-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299993535 FL Primary

Addresses

Primary practice location

8910 N. Dale Mabry Hwy
Suite 16
Tampa, FL 33614

Mailing address

8910 N. Dale Mabry Hwy
Suite 16
Tampa, FL 33614
Phone (813) 935-5555

Other identifiers 1

IdentifierTypeStateIssuer
001442500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100320000154 FL Part A Provider - Home Health Agency 4183759715 Practice locations: Tampa, FL

Home health agency certification: CCN 109648

Legal name
APOLLO ADVANCED HOME HEALTH CORP.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 16, 2010
Last certification
Jul 19, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 5, 2008 in FL
Enrollment address
8910 N Dale Mabry Hwy
Ste 16
Tampa, FL 33614-1580

Care Compare: Home health agency

Medicare Care Compare
Listed as
Apollo Advanced Home Health CorpCCN 109648
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Sep 16, 2010
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
10D1099732Apollo Advanced Home Health, Corp8910 N Dale Mabry Hwy Suite 16, Tampa, FL 33614Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

8910 N Dale Mabry Hwy
Ste 16
Tampa, FL 33614
Phone (813) 935-5555

8910 N Dale Mabry Hwy
Ste 10
Tampa, FL 33614
Phone (813) 935-5555

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
Aimee Marquez Individual Corporate DirectorDon, Alt. Administrator Apr 3, 2017
W-2 Managing EmployeeDon, Alt. Administrator Apr 3, 2017
Operational/Managerial ControlDon, Alt. Administrator Apr 3, 2017
Jose Martinez Individual 5% Or Greater Direct Ownership Interest Dec 5, 2008 100%
Corporate OfficerCeo, President Dec 5, 2008 100%
Corporate DirectorCeo, President Dec 5, 2008 100%
W-2 Managing EmployeeCeo, President Dec 5, 2008 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543276800000",
    "number": "1972741254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 N. DALE MABRY HWY",
            "address_2": "SUITE 16",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-935-5555",
            "fax_number": "813-933-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 N. DALE MABRY HWY",
            "address_2": "SUITE 16",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-935-5555",
            "fax_number": "813-933-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO ADVANCED HOME HEALTH CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2018-11-27",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-935-5555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001442500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.