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General NPI Number Information
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NPI Number | 1104087329
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Entity Type | Organization
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Legal Business Name | ALF SEVILLA HOME CARE CORPORATION
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 10844 SW 154TH TER
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City | MIAMI
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State | FL
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Zip | 33157-1335
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Country | US
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Telephone | 786-573-3111
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Fax | 305-485-1035
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Provider Business Mailing Address
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Address Line | 10844 SW 154TH TER
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City | MIAMI
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State | FL
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Zip | 33157-1335
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Country | US
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Telephone | 786-573-3111
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Fax | 305-485-1035
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LAZARO HERRERA
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Credential |
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Telephone | 786-573-3111
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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 | 10152
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License Number State | FL
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