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General NPI Number Information
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NPI Number | 1265359434
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Entity Type | Organization
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Legal Business Name | COUNTRY WALK CARE, LLC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 14621 SW 143RD PLACE CIR
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City | MIAMI
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State | FL
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Zip | 33186-5670
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Country | US
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Telephone | 305-542-2664
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Fax | 786-701-8274
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Provider Business Mailing Address
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Address Line | 14621 SW 143RD PLACE CIR
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City | MIAMI
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State | FL
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Zip | 33186-5670
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Country | US
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Telephone | 305-542-2664
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Fax | 786-701-8274
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Authorized Official
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Title or Position | OWNER
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Name | MICHEL MARTINEZ MENENDEZ
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Credential |
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Telephone | 305-316-4625
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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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