MEDICARE: LOVING FAMILY SENIOR CARE, 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	:	1689275372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING FAMILY SENIOR CARE, LLC

Provider Business Mailing Address
First Line	:	2323 NW 34TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-5307
Country	:	US
Telephone Number	:	786-486-6911
Fax Number	:	305-359-3507

Provider Business Practice Location Address
First Line	:	2323 NW 34TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-5307
Country	:	US
Telephone Number	:	786-486-6911
Fax Number	:	305-359-3507

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SERGIO AMADOR
Credential	:
Telephone Number	:	786-486-6911

Provider Enumeration Date	:	11/08/2020
Last Update Date	:	11/08/2020

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