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General NPI Number Information
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NPI Number | 1255538328
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Entity Type | Organization
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Legal Business Name | MARTIN RESIDENCES, INC.
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Dates
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Enumeration Date | 07/01/2007
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 19940 SW 124TH CT
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City | MIAMI
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State | FL
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Zip | 33177-4938
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Country | US
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Telephone | 786-457-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 19940 SW 124TH CT
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City | MIAMI
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State | FL
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Zip | 33177-4938
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Country | US
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Telephone | 786-457-0743
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAURICIO MARTIN
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Credential |
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Telephone | 786-457-0743
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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 | AL10058
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License Number State | FL
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