=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831323716
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOSCH ALF, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2009
-----------------------------------------------------
Last Update Date | 03/20/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3060 N.W. 19TH TERR.
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-637-8109
-----------------------------------------------------
Fax | 305-637-8109
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3060 N.W. 19TH TERR.
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-637-8109
-----------------------------------------------------
Fax | 305-637-8109
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMIN.
-----------------------------------------------------
Name | ANABEL BORGES LOPEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-413-8180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | AL10199
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------