MEDICARE: JEAN CARLOS ALF INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033752886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEAN CARLOS ALF INC.

Provider Business Mailing Address
First Line	:	9760 MEMORIAL RD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157
Country	:	US
Telephone Number	:	786-713-0837
Fax Number	:	305-387-1555

Provider Business Practice Location Address
First Line	:	9760 MEMORIAL RD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157
Country	:	US
Telephone Number	:	786-713-0837
Fax Number	:	305-387-1555

Authorized Official
Title or Position	:	OWNER
Name	:	GLADYS GARCIA
Credential	:
Telephone Number	:	786-205-8021

Provider Enumeration Date	:	10/24/2019
Last Update Date	:	06/18/2026

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