=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053551770
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELEN SWEET HOME ALF II INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2009
-----------------------------------------------------
Last Update Date | 11/27/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11825 S.W. 206 ST.
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-255-6750
-----------------------------------------------------
Fax | 305-397-1860
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11825 S.W. 206 ST.
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-255-6750
-----------------------------------------------------
Fax | 305-397-1860
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMIN.
-----------------------------------------------------
Name | JOSEFA ANZARDO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-273-6061
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | AL11532
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------