Healthcare Provider Details

I. General information

NPI: 1376503920
Provider Name (Legal Business Name): SEFARDIK ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3671 S MIAMI AVE
MIAMI FL
33133-4253
US

IV. Provider business mailing address

3671 S MIAMI AVE
MIAMI FL
33133-4253
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-1110
  • Fax: 305-854-2827
Mailing address:
  • Phone: 305-854-1110
  • Fax: 305-854-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1627096
License Number StateFL

VIII. Authorized Official

Name: MR. PHILIP ESFORMES
Title or Position: OWNER
Credential:
Phone: 305-854-1110