Healthcare Provider Details

I. General information

NPI: 1740821206
Provider Name (Legal Business Name): COVADONGA CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 NW 183RD ST STE 122
HIALEAH FL
33015-6009
US

IV. Provider business mailing address

5901 NW 183RD ST STE 122
HIALEAH FL
33015-6009
US

V. Phone/Fax

Practice location:
  • Phone: 786-683-1341
  • Fax:
Mailing address:
  • Phone: 786-683-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ELISABEHT HIDALGO
Title or Position: CEO
Credential:
Phone: 786-683-1341