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General NPI Number Information
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NPI Number | 1003303835
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Entity Type | Organization
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Legal Business Name | LAS OVAS ALF CORP.
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 1214 MEADOWBROOK DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5430
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Country | US
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Telephone | 561-513-9149
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Fax | 561-530-7779
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Provider Business Mailing Address
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Address Line | 1214 MEADOWBROOK DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5430
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Country | US
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Telephone | 561-513-9149
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Fax | 561-530-7779
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | NEUDIS PEREZ PUPO
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Credential |
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Telephone | 561-856-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 13137
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License Number State | FL
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