Healthcare Provider Details

I. General information

NPI: 1225453590
Provider Name (Legal Business Name): STAT HEALTHCARE AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NW 176TH ST STE 200-3
MIAMI GARDENS FL
33169-5023
US

IV. Provider business mailing address

160 NW 176TH ST STE 306
MIAMI GARDENS FL
33169-5041
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-6103
  • Fax: 305-460-2269
Mailing address:
  • Phone: 305-651-6103
  • Fax: 305-460-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994239
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ROCHENEL ALBERT
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-651-6103