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General NPI Number Information
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NPI Number | 1801841036
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Entity Type | Organization
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Legal Business Name | HARBOR BEACH HEALTH CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 05/26/2013
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Provider Practice Location Address
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Address Line | 1615 MIAMI RD
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2933
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Country | US
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Telephone | 954-523-5673
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Fax | 954-523-3010
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Provider Business Mailing Address
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Address Line | 1615 MIAMI RD
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2933
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Country | US
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Telephone | 954-523-5673
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Fax | 954-523-3010
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Authorized Official
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Title or Position | MANAGER
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Name | ROLAND MENEZIL
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Credential |
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Telephone | 954-523-5673
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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 | SNF11940963
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License Number State | FL
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