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General NPI Number Information
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NPI Number | 1164062600
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Entity Type | Organization
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Legal Business Name | BRITO'S HOME 3 LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 19059 NW 77TH PL
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-5257
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Country | US
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Telephone | 786-565-9090
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Fax | 786-320-6165
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Provider Business Mailing Address
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Address Line | 19059 NW 77TH PL
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-5257
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Country | US
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Telephone | 786-565-9090
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Fax | 786-320-6165
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | VIRGINIA BRITO
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Credential |
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Telephone | 786-853-5569
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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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