Provider Demographics
NPI:1245800663
Name:AEGIS HOMECARE LLC
Entity Type:Organization
Organization Name:AEGIS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ORO GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:789-558-4067
Mailing Address - Street 1:8660 W FLAGLER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2035
Mailing Address - Country:US
Mailing Address - Phone:786-558-4067
Mailing Address - Fax:786-786-9889
Practice Address - Street 1:8660 W FLAGLER ST STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2035
Practice Address - Country:US
Practice Address - Phone:786-558-4067
Practice Address - Fax:786-786-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113493000Medicaid
FL299995386OtherHOME HEALTH LICENSE