MEDICARE: 239 NE 24 AVENUE INVESTMENTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1003748278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	239 NE 24 AVENUE INVESTMENTS LLC

Provider Business Mailing Address
First Line	:	12806 SW 30TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-5301
Country	:	US
Telephone Number	:	305-525-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 NE 24TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-4825
Country	:	US
Telephone Number	:	305-525-1449
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL ANANIAN
Credential	:
Telephone Number	:	305-525-1449

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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