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General NPI Number Information
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NPI Number | 1992003396
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Entity Type | Organization
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Legal Business Name | GABLES MANOR INDEPENDENT INC
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1535 VENETIA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-2171
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Country | US
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Telephone | 305-772-1367
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 VENETIA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-2171
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Country | US
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Telephone | 305-772-1367
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LAZARA WONG ROMERO
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Credential |
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Telephone | 305-772-1367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL-7926
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License Number State | FL
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