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General NPI Number Information
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NPI Number | 1225211774
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Entity Type | Organization
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Legal Business Name | SANTA FLORA ALF, INC.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 19005 SW 320 STREET
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City | HOMESTEAD
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State | FL
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Zip | 33030-5301
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Country | US
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Telephone | 305-247-3454
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Fax | 786-601-9006
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Provider Business Mailing Address
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Address Line | 19005 SW 320 STREET
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City | HOMESTEAD
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State | FL
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Zip | 33030-5301
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Country | US
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Telephone | 305-247-3454
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Fax | 786-601-9006
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ALEIDA QUINTANA
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Credential |
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Telephone | 305-219-0392
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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 | 11155
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License Number State | FL
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