MEDICARE: KEVIN'S 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

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	:	1497142541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN'S ALF CORP

Provider Business Mailing Address
First Line	:	5111 SW 112TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-6941
Country	:	US
Telephone Number	:	786-400-5335
Fax Number	:	305-274-5631

Provider Business Practice Location Address
First Line	:	5111 SW 112TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-6941
Country	:	US
Telephone Number	:	786-400-5335
Fax Number	:	305-274-5631

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ZAIRYS GARIT
Credential	:
Telephone Number	:	786-400-5335

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	07/03/2019

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Directions to “KEVIN'S ALF CORP ” Practice Location

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