Healthcare Provider Details

I. General information

NPI: 1013375971
Provider Name (Legal Business Name): AMY'S ANGELS HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92200 OVERSEAS HWY STE 124
TAVERNIER FL
33070-2773
US

IV. Provider business mailing address

92200 OVERSEAS HWY STE 124
TAVERNIER FL
33070-2773
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-0695
  • Fax:
Mailing address:
  • Phone: 786-391-0695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMADA T ALFONSO
Title or Position: OWNER
Credential:
Phone: 786-391-0695