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General NPI Number Information
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NPI Number | 1720478001
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Entity Type | Organization
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Legal Business Name | CORAL SAND, INC.
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 7800 ABBOTT AVENUE
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City | MIAMI BEACH
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State | FL
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Zip | 33141-2022
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Country | US
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Telephone | 305-867-3232
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Fax | 305-867-9894
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Provider Business Mailing Address
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Address Line | 7800 ABBOTT AVENUE
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City | MIAMI BEACH
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State | FL
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Zip | 33141-2022
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Country | US
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Telephone | 305-867-3232
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Fax | 305-867-9894
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER CARDOSO
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Credential |
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Telephone | 786-246-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL9375
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License Number State | FL
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