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General NPI Number Information
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NPI Number | 1326427337
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Entity Type | Organization
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Legal Business Name | BMA ASSISTED LIVING FACILITY, CORP.
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 12381 S.W. 144 TERR
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 786-701-9860
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Fax | 305-328-6663
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Provider Business Mailing Address
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Address Line | 12381 S.W. 144 TERR
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 786-701-9860
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Fax | 305-328-6663
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Authorized Official
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Title or Position | OWNER
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Name | BRANDO HERNANDEZ
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Credential |
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Telephone | 305-496-3798
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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 | 11275
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License Number State | FL
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