MEDICARE: MY BELLS ALF 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	AL 11396	FL

General Provider Information

NPI Number	:	1134410210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY BELLS ALF CORP

Provider Business Mailing Address
First Line	:	2161 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2161 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3726
Country	:	US
Telephone Number	:	786-376-2214
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	REYNALDO LUCERO
Credential	:
Telephone Number	:	786-376-2214

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	04/25/2011

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Directions to “MY BELLS ALF CORP ” Practice Location

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