Healthcare Provider Details

I. General information

NPI: 1063762979
Provider Name (Legal Business Name): CROSS GARDENS CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 NE 191ST ST
MIAMI FL
33179-3711
US

IV. Provider business mailing address

4700 SHERIDAN ST SUITE B
HOLLYWOOD FL
33021-3420
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-9690
  • Fax: 305-654-9123
Mailing address:
  • Phone: 954-367-4563
  • Fax: 954-367-4564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET H FERNANDEZ
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 954-367-4563