Provider Demographics
NPI:1568563997
Name:AMERICA PRESTIGE SERVICES CORP
Entity Type:Organization
Organization Name:AMERICA PRESTIGE SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-512-0941
Mailing Address - Street 1:2017 W 62ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2678
Mailing Address - Country:US
Mailing Address - Phone:305-512-0941
Mailing Address - Fax:305-512-0942
Practice Address - Street 1:2017 W 62ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2678
Practice Address - Country:US
Practice Address - Phone:305-512-0941
Practice Address - Fax:305-512-0942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH 232013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN NUMBER
FL=========OtherEIN NUMBER