Healthcare Provider Details

I. General information

NPI: 1063325884
Provider Name (Legal Business Name): LIGHTHOUSE CARE REGISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 WATERFORD DISTRICT DR STE 400
MIAMI FL
33126-6040
US

IV. Provider business mailing address

5830 SW 144TH CIRCLE PL
MIAMI FL
33183-1069
US

V. Phone/Fax

Practice location:
  • Phone: 786-439-8939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIA SANTANA
Title or Position: CEO
Credential:
Phone: 786-439-8939