Healthcare Provider Details

I. General information

NPI: 1134044597
Provider Name (Legal Business Name): EVERTRUST CARE REGISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5082 NW 74TH AVE UNIT B
MIAMI FL
33166-5554
US

IV. Provider business mailing address

5082 NW 74TH AVE UNIT B
MIAMI FL
33166-5554
US

V. Phone/Fax

Practice location:
  • Phone: 786-820-0362
  • Fax: 305-307-1910
Mailing address:
  • Phone: 786-820-0362
  • Fax: 305-307-1910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care 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 Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: THALIA HERNANDEZ VALLE
Title or Position: PRESIDENT
Credential:
Phone: 786-820-0362