1831256619 NPI number — A & A HEALTH SERVICE, INC.

Table of content: (NPI 1831256619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831256619 NPI number — A & A HEALTH SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & A HEALTH SERVICE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831256619
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3408 W 84TH ST
Provider Second Line Business Mailing Address:
BUILDING G, SUITE 204
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33018-4939
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-825-2112
Provider Business Mailing Address Fax Number:
305-825-2242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3408 W 84TH ST
Provider Second Line Business Practice Location Address:
BUILDING G, SUITE 204
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33018-4939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-825-2112
Provider Business Practice Location Address Fax Number:
305-825-2242
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DELGADO-GARCIA
Authorized Official First Name:
MARICELA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
305-825-2112

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA299991638 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 650983500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 686513596 . This is a "AREA XI HOME & COMMUNITY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 686513598 . This is a "AREA XI FAMILY & SUPPORTE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 265466 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 6000201 . This is a "EVERCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 686513579 . This is a "BRAIN & SPINE CORD WAIVER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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