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General NPI Number Information
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NPI Number | 1538321559
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Entity Type | Organization
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Legal Business Name | LIZMARY SENIOR CARE
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 16671 SW 52ND LN
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City | MIAMI
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State | FL
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Zip | 33185-5274
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Country | US
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Telephone | 305-228-0972
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Fax | 305-228-0972
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Provider Business Mailing Address
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Address Line | 16671 SW 52ND LN
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City | MIAMI
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State | FL
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Zip | 33185-5274
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS LUIS TALAVERA
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Credential |
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Telephone | 305-228-0972
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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 | AL11096
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License Number State | FL
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