MEDICARE: ANGEL ALF

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	AL10045	FL

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	:	1952512758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL ALF

Provider Business Mailing Address
First Line	:	9605 SW 144TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6941
Country	:	US
Telephone Number	:	786-539-6851
Fax Number	:	305-382-2353

Provider Business Practice Location Address
First Line	:	9605 SW 144TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6941
Country	:	US
Telephone Number	:	786-539-6851
Fax Number	:	305-382-2353

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAYLIN DELGADO
Credential	:
Telephone Number	:	786-539-6851

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	12/09/2009

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Directions to “ANGEL ALF ” Practice Location

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