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NPI Code Detail

MEDICARE: DAMABIAN ALF CENTER

MEDICARE: DAMABIAN ALF CENTER
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
1310400000XAssisted Living FacilityAL 10121FL

General Provider Information

NPI Number : 1407064264
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAMABIAN ALF CENTER
Provider Business Mailing Address
First Line : 4065 NW 4TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-5673
Country : US
Telephone Number : 305-643-3095
Fax Number : 305-225-1289
Provider Business Practice Location Address
First Line : 4065 NW 4TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-5673
Country : US
Telephone Number : 305-643-3095
Fax Number : 305-225-1289
Authorized Official
Title or Position : OWNER
Name : ALINA HERNANDEZ
Credential :
Telephone Number : 305-643-3095
Provider Enumeration Date : 05/17/2007
Last Update Date : 08/22/2020

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