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General NPI Number Information
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NPI Number | 1780696336
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Entity Type | Organization
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Legal Business Name | PALMETTO SUB ACUTE CARE CENTER INC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 7600 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4462
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Country | US
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Telephone | 305-261-2525
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Fax | 305-261-5232
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Provider Business Mailing Address
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Address Line | 7600 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4462
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Country | US
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Telephone | 305-261-2525
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Fax | 305-261-5232
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KHALID MIRZA
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Credential |
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Telephone | 305-261-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF 1423096
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License Number State | FL
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