MEDICARE: LATIN ANGELS FOR HOMECARE LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	251B00000X	Case Management Agency
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578290854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATIN ANGELS FOR HOMECARE LLC.

Provider Business Mailing Address
First Line	:	7619 COOT ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-7705
Country	:	US
Telephone Number	:	407-385-3470
Fax Number	:	407-610-6756

Provider Business Practice Location Address
First Line	:	199 AVENUE B NW STE 200-3
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4546
Country	:	US
Telephone Number	:	407-385-3470
Fax Number	:	407-610-6756

Authorized Official
Title or Position	:	CEO
Name	:	PEDRO PENA CUESTA
Credential	:
Telephone Number	:	786-238-5632

Provider Enumeration Date	:	08/05/2022
Last Update Date	:	12/02/2025

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