Provider Demographics
NPI:1679632483
Name:ALBORADA HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:ALBORADA HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-559-1005
Mailing Address - Street 1:953 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2406
Mailing Address - Country:US
Mailing Address - Phone:305-559-1005
Mailing Address - Fax:305-559-5303
Practice Address - Street 1:953 SW 122ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2406
Practice Address - Country:US
Practice Address - Phone:305-559-1005
Practice Address - Fax:305-559-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992579251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651500200Medicaid
FL109004Medicare Oscar/Certification