Healthcare Provider Details
I. General information
NPI: 1740486000
Provider Name (Legal Business Name): KELLEY A.L.F. CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10410 SW 127TH AVE
MIAMI FL
33186-3516
US
IV. Provider business mailing address
10410 SW 127TH AVE
MIAMI FL
33186-3516
US
V. Phone/Fax
- Phone: 786-303-6637
- Fax:
- Phone: 786-303-6637
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | AL10880 |
| License Number State | FL |
VIII. Authorized Official
Name:
MARTA
CASTELL
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 305-385-7690