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NPI Code Detail

MEDICARE: PINES NURSING HOME 77 INC

MEDICARE: PINES NURSING HOME 77 INC
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
1314000000XSkilled Nursing FacilitySNF 1442096FL

General Provider Information

NPI Number : 1841298163
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINES NURSING HOME 77 INC
Provider Business Mailing Address
First Line : 301 NE 141ST ST
Second Line :
City : MIAMI
State : FL
Zip : 33161-2837
Country : US
Telephone Number : 305-893-1102
Fax Number : 305-893-2519
Provider Business Practice Location Address
First Line : 301 NE 141ST ST
Second Line :
City : MIAMI
State : FL
Zip : 33161-2837
Country : US
Telephone Number : 305-893-1102
Fax Number : 305-893-2519
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JULES AST
Credential : NHA
Telephone Number : 305-893-1102
Provider Enumeration Date : 07/11/2005
Last Update Date : 08/22/2020

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Directions to “PINES NURSING HOME 77 INC ” Practice Location

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