MEDICARE: GREYNOLDS PARK MANOR

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	314000000X	Skilled Nursing Facility	SNF1184096	FL

General Provider Information

NPI Number	:	1578551529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREYNOLDS PARK MANOR

Provider Business Mailing Address
First Line	:	17400 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17400 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4818
Country	:	US
Telephone Number	:	305-944-2361
Fax Number	:	305-949-9464

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MARTIN E CASPER
Credential	:
Telephone Number	:	305-944-2361

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1588558423 — ACCESS MEDICAL GROUP OF MIAMI MEDICARE, LLC
Practice Location Address:

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141

1578650719 — C & P LABORATORIES, INC
Practice Location Address:

12995 NE 7TH AVE
NORTH MIAMI, FL
33161-4818

Practice Phone: 305-981-7666
Practice Fax:

1871450106 — OPALO HAUS BY CHARM LLC
Practice Location Address:

4760 SW 141ST AVE
MIAMI, FL
33175-4818

Practice Phone: 786-525-6809
Practice Fax: 305-530-8113

1750518460 — DR. LISA ELLEN GRAHAM MSTOM
Practice Location Address:

6301 SUNSET DR , SUITE 201
SOUTH MIAMI, FL
33143-4818

Practice Phone: 305-669-2715
Practice Fax:

1477079762 — GRETTEL CANEDO VALDES
Practice Location Address:

244 NW 57TH AVE APT 4
MIAMI, FL
33126-4818

Practice Phone: 786-560-4693
Practice Fax:

1003699455 — CAROL REIGOSA
Practice Location Address:

244 NW 57TH AVE APT 4
MIAMI, FL
33126-4818

Practice Phone: 786-560-4697
Practice Fax:

Directions to “GREYNOLDS PARK MANOR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.