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General NPI Number Information
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NPI Number | 1477021616
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Entity Type | Organization
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Legal Business Name | EAGLES EYE COMFORT CARE MIRAMAR
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 03/09/2019
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Provider Practice Location Address
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Address Line | 8620 NW 3RD ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6567
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Country | US
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Telephone | 954-232-1389
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Fax |
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Provider Business Mailing Address
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Address Line | 6308 SW 27TH ST
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City | MIRAMAR
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State | FL
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Zip | 33023-3920
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Country | US
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Telephone | 954-232-1389
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GLORIA JUMPP
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Credential |
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Telephone | 954-232-1389
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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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