Healthcare Provider Details

I. General information

NPI: 1871450106
Provider Name (Legal Business Name): OPALO HAUS BY CHARM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 SW 141ST AVE
MIAMI FL
33175-4818
US

IV. Provider business mailing address

4760 SW 141ST AVE
MIAMI FL
33175-4818
US

V. Phone/Fax

Practice location:
  • Phone: 786-525-6809
  • Fax: 305-530-8113
Mailing address:
  • Phone: 786-525-6809
  • Fax: 305-530-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YUDITH LOPEZ
Title or Position: OWNER
Credential:
Phone: 786-525-6809