Healthcare Provider Details

I. General information

NPI: 1043137318
Provider Name (Legal Business Name): ANGELS HOME CARE PROVIDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CALLE TRES APT 1223
KEY WEST FL
33040-5573
US

IV. Provider business mailing address

12 CALLE TRES APT 1223
KEY WEST FL
33040-5573
US

V. Phone/Fax

Practice location:
  • Phone: 305-290-0685
  • Fax:
Mailing address:
  • Phone: 305-290-0685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: YUDIMILA TAMARIT BENITEZ
Title or Position: OWNER
Credential:
Phone: 305-290-0685