MEDICARE: AMIGOS ALF HOMES CORP

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	12860	FL

General Provider Information

NPI Number	:	1194276766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMIGOS ALF HOMES CORP

Provider Business Mailing Address
First Line	:	2710 SW 77TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-2635
Country	:	US
Telephone Number	:	305-283-2471
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 SW 77TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-2635
Country	:	US
Telephone Number	:	305-283-2471
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOURDES MARTINEZ
Credential	:
Telephone Number	:	305-283-2471

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	10/19/2016

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Directions to “AMIGOS ALF HOMES CORP ” Practice Location

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