MEDICARE: WEST DIXIE CARE, 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	314000000X	Skilled Nursing Facility	800006324	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	:	1144219817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST DIXIE CARE, LLC

Provider Business Mailing Address
First Line	:	16650 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3713
Country	:	US
Telephone Number	:	305-945-7447
Fax Number	:	305-945-7278

Provider Business Practice Location Address
First Line	:	16650 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3713
Country	:	US
Telephone Number	:	305-945-7447
Fax Number	:	305-945-7278

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GILDA ANDERSON
Credential	:
Telephone Number	:	305-945-7447

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	05/12/2009

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