MEDICARE: SENIOR HEALTHCARE SERVICES LLC

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	152W00000X	Optometrist
2	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1053282715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1416 BAY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-3703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 LINCOLN RD STE 500
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2439
Country	:	US
Telephone Number	:	404-626-8957
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	CORDELIA JERNIGAN
Credential	:
Telephone Number	:	404-626-8957

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	09/16/2025

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