Provider Demographics
NPI:1194417659
Name:MAEANGELS LLC
Entity type:Organization
Organization Name:MAEANGELS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEGONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-367-6256
Mailing Address - Street 1:221 E. DIXIE COURT
Mailing Address - Street 2:UNIT 205
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:754-367-6256
Mailing Address - Fax:
Practice Address - Street 1:221 E. DIXIE COURT
Practice Address - Street 2:UNIT 205
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311
Practice Address - Country:US
Practice Address - Phone:754-367-6256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health