Healthcare Provider Details

I. General information

NPI: 1417674714
Provider Name (Legal Business Name): 840 SW 8TH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 SW 8TH ST
POMPANO BEACH FL
33060-8214
US

IV. Provider business mailing address

10001 W OAKLAND PARK BLVD STE 302
SUNRISE FL
33351-6925
US

V. Phone/Fax

Practice location:
  • Phone: 855-331-6615
  • Fax:
Mailing address:
  • Phone: 855-331-6615
  • Fax:

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: MR. ANDRES DUARTES
Title or Position: OWNER
Credential:
Phone: 305-409-0949