Provider Demographics
NPI:1033291877
Name:ANGEL CARE LLC
Entity type:Organization
Organization Name:ANGEL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MIALGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-431-9777
Mailing Address - Street 1:16201 SW 95TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3459
Mailing Address - Country:US
Mailing Address - Phone:305-256-1599
Mailing Address - Fax:305-256-1597
Practice Address - Street 1:16201 SW 95TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3459
Practice Address - Country:US
Practice Address - Phone:305-256-1599
Practice Address - Fax:305-256-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health