MEDICARE: ALF FAMILY PALACE CORP

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	9785	FL

General Provider Information

NPI Number	:	1073939492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALF FAMILY PALACE CORP

Provider Business Mailing Address
First Line	:	7521 W 30TH LN
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5245
Country	:	US
Telephone Number	:	305-822-9351
Fax Number	:

Provider Business Practice Location Address
First Line	:	7521 W 30TH LN
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5245
Country	:	US
Telephone Number	:	305-822-9351
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YAMIR MENENDEZ
Credential	:
Telephone Number	:	305-822-9351

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	03/10/2014

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Directions to “ALF FAMILY PALACE CORP ” Practice Location

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