MEDICARE: OPALO HAUS BY CHARM 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	:	1871450106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPALO HAUS BY CHARM LLC

Provider Business Mailing Address
First Line	:	4760 SW 141ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4818
Country	:	US
Telephone Number	:	786-525-6809
Fax Number	:	305-530-8113

Provider Business Practice Location Address
First Line	:	4760 SW 141ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4818
Country	:	US
Telephone Number	:	786-525-6809
Fax Number	:	305-530-8113

Authorized Official
Title or Position	:	OWNER
Name	:	YUDITH LOPEZ
Credential	:
Telephone Number	:	786-525-6809

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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