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General NPI Number Information
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NPI Number | 1457584245
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Entity Type | Organization
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Legal Business Name | MARTIN ELDERLY CARE,INC
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 901 NW 63 ST
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City | MIAMI
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State | FL
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Zip | 33150
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Country | US
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Telephone | 305-762-4242
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Fax | 305-762-4242
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Provider Business Mailing Address
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Address Line | 901 NW 63RD ST
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City | MIAMI
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State | FL
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Zip | 33150-4220
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Country | US
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Telephone | 305-762-4242
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Fax |
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Authorized Official
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Title or Position | ASISTADE LIVING ADMINISTRATOR
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Name | MS. LOUISE LEGER ELISE
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Credential | LPN
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Telephone | 305-762-4242
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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 | 141714200
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License Number State | FL
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