MEDICARE: ANGIE'S HOME HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1427090141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGIE'S HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	13255 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5326
Country	:	US
Telephone Number	:	305-251-7698
Fax Number	:	305-251-7814

Provider Business Practice Location Address
First Line	:	13255 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5326
Country	:	US
Telephone Number	:	305-251-7698
Fax Number	:	305-251-7814

Authorized Official
Title or Position	:	OWNER/DON
Name	:	MS. ANGELA MARIA BUSTILLO
Credential	:
Telephone Number	:	305-251-7698

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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