Healthcare Provider Details

I. General information

NPI: 1598913303
Provider Name (Legal Business Name): CORAL GABLES ALF NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S LE JEUNE RD
CORAL GABLES FL
33134-4252
US

IV. Provider business mailing address

PO BOX 140151
CORAL GABLES FL
33114-0151
US

V. Phone/Fax

Practice location:
  • Phone: 305-300-9241
  • Fax:
Mailing address:
  • Phone: 305-300-9241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. BLANCA VAZQUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-300-9241