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General NPI Number Information
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NPI Number | 1073845236
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Entity Type | Organization
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Legal Business Name | OASIS ADULT CARE
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 15058 SW 63RD ST
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City | MIAMI
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State | FL
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Zip | 33193-2771
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Country | US
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Telephone | 786-942-2799
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Fax |
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Provider Business Mailing Address
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Address Line | 15058 SW 63RD ST
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City | MIAMI
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State | FL
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Zip | 33193-2771
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Country | US
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Telephone | 786-942-2799
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MAGDA CRISTINA NIETO
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Credential |
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Telephone | 783-942-2799
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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 | AL11302
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License Number State | FL
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