Healthcare Provider Details

I. General information

NPI: 1205769767
Provider Name (Legal Business Name): MIRIAM'S GRACE HOME HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 ARLINGTON EXPY
JACKSONVILLE FL
32211-5779
US

IV. Provider business mailing address

6501 ARLINGTON EXPY
JACKSONVILLE FL
32211-5779
US

V. Phone/Fax

Practice location:
  • Phone: 305-389-5566
  • Fax:
Mailing address:
  • Phone: 305-389-5566
  • 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
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MISS ANGELA LOMOTEY
Title or Position: CEO/OWNER
Credential:
Phone: 305-389-5566