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NPI Code Detail

MEDICARE: LA ESTACION DORADA LLC

MEDICARE: LA ESTACION DORADA 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
1310400000XAssisted Living Facility11627FL

General Provider Information

NPI Number : 1700134764
Entity Type Code : Organization
Provider Name (Legal Business Name) : LA ESTACION DORADA LLC
Provider Business Mailing Address
First Line : 1230 SW 94TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33174-3046
Country : US
Telephone Number : 305-710-4543
Fax Number :
Provider Business Practice Location Address
First Line : 1230 SW 94TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33174-3046
Country : US
Telephone Number : 305-710-4543
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : CELSA ALVAREZ
Credential :
Telephone Number : 305-710-4543
Provider Enumeration Date : 08/23/2012
Last Update Date : 08/23/2012

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Directions to “LA ESTACION DORADA LLC ” Practice Location

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