MEDICARE: AVENTURA SNF 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	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790243822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVENTURA SNF LLC

Provider Business Mailing Address
First Line	:	400 RELLA BLVD STE 200
Second Line	:
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-4239
Country	:	US
Telephone Number	:	845-490-6060
Fax Number	:	845-230-8711

Provider Business Practice Location Address
First Line	:	1800 NE 168TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3023
Country	:	US
Telephone Number	:	305-947-3445
Fax Number	:	305-917-1818

Authorized Official
Title or Position	:	AUTHORIZED MEMBER
Name	:	LEOPOLD FRIEDMAN
Credential	:
Telephone Number	:	845-746-5082

Provider Enumeration Date	:	03/07/2019
Last Update Date	:	03/07/2019

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Directions to “AVENTURA SNF LLC ” Practice Location

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