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General NPI Number Information
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NPI Number | 1912166091
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Entity Type | Organization
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Legal Business Name | VILLA MARIA NURSING & REHABILITATION CENTER
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 8850 NW 122ND ST
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1748
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Country | US
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Telephone | 305-731-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 4790 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5860
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Country | US
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Telephone | 954-484-1515
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Fax | 954-484-5416
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MARY JO FRICK
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Credential |
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Telephone | 954-484-1515
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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 | SNF130471041
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License Number State | FL
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