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General NPI Number Information
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NPI Number | 1598333585
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Entity Type | Organization
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Legal Business Name | MIA'S ADULT CARE ALF LLC
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 6524 SW 148TH PL
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City | MIAMI
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State | FL
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Zip | 33193-2013
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Country | US
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Telephone | 305-382-9410
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Fax | 305-387-8843
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Provider Business Mailing Address
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Address Line | 6524 SW 148TH PL
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City | MIAMI
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State | FL
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Zip | 33193-2013
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Country | US
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Telephone | 305-382-9410
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Fax | 305-387-8843
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Authorized Official
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Title or Position | OWNER
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Name | GISELLE GINARTE
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Credential |
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Telephone | 786-619-4464
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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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