Provider Demographics
NPI:1467213397
Name:FLOR DE MARGARITA HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:FLOR DE MARGARITA HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIA
Authorized Official - Middle Name:ESPERANZA
Authorized Official - Last Name:MALDONADO PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-977-9343
Mailing Address - Street 1:PO BOX 72116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87195
Mailing Address - Country:US
Mailing Address - Phone:505-977-9343
Mailing Address - Fax:
Practice Address - Street 1:7129 ISLETA BLVD. SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105
Practice Address - Country:US
Practice Address - Phone:505-977-9343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty