MEDICARE: MY KIND HOME ALF

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	AL10486	FL

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	:	1124284070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY KIND HOME ALF

Provider Business Mailing Address
First Line	:	1846 SW 22ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3822
Country	:	US
Telephone Number	:	786-348-9405
Fax Number	:	305-828-1511

Provider Business Practice Location Address
First Line	:	1846 SW 22ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3822
Country	:	US
Telephone Number	:	786-348-9405
Fax Number	:	305-828-1511

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MAYREN SARDINAS
Credential	:
Telephone Number	:	786-348-9405

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

Similar Medicare Providers

1588558423 — ACCESS MEDICAL GROUP OF MIAMI MEDICARE, LLC
Practice Location Address:

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141

1952824583 — SUSEL REINA MONTERO
Practice Location Address:

1830 SW 22ND TER
MIAMI, FL
33145-3822

Practice Phone: 305-922-3031
Practice Fax:

1528074002 — SOUTH BEACH PSYCHOLOGY INC
Practice Location Address:

3328 GARDEN AVE
MIAMI BEACH, FL
33140-3822

Practice Phone: 786-303-4422
Practice Fax:

1457600710 — MS. MICHAELLE JEAN-CHARLES LPN
Practice Location Address:

1180 NE 137TH ST
NORTH MIAMI, FL
33161-3822

Practice Phone: 786-370-9672
Practice Fax:

1437602448 — ILEN ORTIZ PUEBLA
Practice Location Address:

1450 NW 51ST TER
MIAMI, FL
33142-3822

Practice Phone: 786-856-1932
Practice Fax:

1861904393 — VIVIANA LOPEZ
Practice Location Address:

3822 SW 136TH AVE
MIAMI, FL
33175-3230

Practice Phone: 786-267-3077
Practice Fax:

Directions to “MY KIND HOME ALF ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.