Healthcare Provider Details

I. General information

NPI: 1255251054
Provider Name (Legal Business Name): MIGHTY WINGS COMPANION CAREGIVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 FOX SQUIRREL DR
DAVENPORT FL
33897-9524
US

IV. Provider business mailing address

1339 FOX SQUIRREL DR
DAVENPORT FL
33897-9524
US

V. Phone/Fax

Practice location:
  • Phone: 786-975-3189
  • Fax:
Mailing address:
  • Phone: 786-975-3189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MYRIAME LUBIN
Title or Position: OWNER
Credential: LUBIN
Phone: 786-975-3189