Healthcare Provider Details

I. General information

NPI: 1255534590
Provider Name (Legal Business Name): ROYAL LIVING REST HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2926 SW 2ND ST
MIAMI FL
33135-1329
US

IV. Provider business mailing address

2926 SW 2ND ST
MIAMI FL
33135-1329
US

V. Phone/Fax

Practice location:
  • Phone: 305-527-0839
  • Fax:
Mailing address:
  • Phone: 305-527-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number8886
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number8886
License Number StateFL

VIII. Authorized Official

Name: BARBARA PEREZ
Title or Position: OWNER
Credential:
Phone: 305-527-0839