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General NPI Number Information
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NPI Number | 1568765709
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Entity Type | Organization
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Legal Business Name | JOSE YOANDRY ALF
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 2916 NW 31ST ST
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City | MIAMI
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State | FL
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Zip | 33142-5844
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Country | US
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Telephone | 305-635-9881
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 NW 31ST ST
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City | MIAMI
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State | FL
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Zip | 33142-5844
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Country | US
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Telephone | 305-635-9881
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOSE PENA
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Credential |
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Telephone | 786-303-8859
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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 | AL11443
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License Number State | FL
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