NPI Code Detail JSON Logo

1174017495 NPI number — WINGS OF AN ANGEL INC

NPI Number: 1174017495
Health Care Provider/Practitioner: WINGS OF AN ANGEL INC

Information about “1174017495” NPI (WINGS OF AN ANGEL INC) exists in 1174017495 in HTML format HTML  |  1174017495 in plain Text format TXT  |  1174017495 in PDF (Portable Document Format) PDF  |  1174017495 in an XML format XML  formats.

NPI Number : 1174017495 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174017495",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "WINGS OF AN ANGEL INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7957 ORLEANS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIRAMAR",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33023-3561",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-985-0690",
    "MailingAddressFaxNumber": "754-888-9175",
    "FirstLinePracticeLocationAddress": "3600 S STATE ROAD 7 STE 21",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIRAMAR",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33023-5288",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "754-888-9074",
    "PracticeLocationAddressFaxNumber": "754-888-9110",
    "EnumerationDate": "06/20/2018",
    "LastUpdateDate": "10/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DOUGLAS",
    "AuthorizedOfficialFirstName": "DENEZE",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "786-985-0690",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251E00000X",
          "TaxonomyName": "Home Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "372600000X",
          "TaxonomyName": "Adult Companion",
          "LicenseNumber": "24912",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374U00000X",
          "TaxonomyName": "Home Health Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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