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General NPI Number Information
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NPI Number | 1154922318
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE 5081 LLC
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 5081 NW DUNN RD
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City | FORT PIERCE
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State | FL
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Zip | 34981-4942
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Country | US
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Telephone | 772-464-0728
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Fax | 561-584-7505
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Provider Business Mailing Address
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Address Line | 4285 NW 66TH PL
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City | BOCA RATON
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State | FL
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Zip | 33496-4029
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Country | US
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Telephone | 561-990-8089
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Fax | 561-584-7505
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Authorized Official
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Title or Position | CFO
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Name | MRS. CLAUDIA A MARINOFF
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Credential |
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Telephone | 561-990-8089
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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 |
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License Number State |
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