Provider Demographics
NPI:1578013033
Name:AJ CARE INC
Entity Type:Organization
Organization Name:AJ CARE INC
Other - Org Name:AJ CARE OF FLORIDA, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AZUCENA
Authorized Official - Middle Name:PREAGIDO
Authorized Official - Last Name:JUMAPAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-202-4048
Mailing Address - Street 1:11990 MELLOW CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-9127
Mailing Address - Country:US
Mailing Address - Phone:561-202-4048
Mailing Address - Fax:
Practice Address - Street 1:11990 MELLOW CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-9127
Practice Address - Country:US
Practice Address - Phone:561-202-4048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-09
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74493311Z00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG77049Medicare UPIN