Provider Demographics
NPI:1952184871
Name:SKY MIRACLES SERVICES, LLC
Entity Type:Organization
Organization Name:SKY MIRACLES SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-844-5740
Mailing Address - Street 1:279 RAMBLING CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:279 RAMBLING CIR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3473
Practice Address - Country:US
Practice Address - Phone:407-844-5740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care