MEDICARE: RANMAR GARDENS

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

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	:	1215202478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANMAR GARDENS

Provider Business Mailing Address
First Line	:	1454 NE 56TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33334-6112
Country	:	US
Telephone Number	:	954-491-7396
Fax Number	:	954-667-0042

Provider Business Practice Location Address
First Line	:	1454 NE 56TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33334-6112
Country	:	US
Telephone Number	:	954-491-7396
Fax Number	:	954-667-0042

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MARJORIE E STEWART
Credential	:	ADMINISTATIVE
Telephone Number	:	954-491-7396

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	10/11/2018

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Directions to “RANMAR GARDENS ” Practice Location

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