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NPI Code Detail

MEDICARE: RESIDENTIAL PLAZA AT BLUE LAGOON

MEDICARE: RESIDENTIAL PLAZA AT BLUE LAGOON
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
1310400000XAssisted Living FacilityAL7551FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548546559
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESIDENTIAL PLAZA AT BLUE LAGOON
Provider Business Mailing Address
First Line : 5617 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-3216
Country : US
Telephone Number : 305-267-2700
Fax Number : 305-267-2708
Provider Business Practice Location Address
First Line : 5617 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-3216
Country : US
Telephone Number : 305-267-2700
Fax Number : 305-267-2708
Authorized Official
Title or Position : ADMINISTRATOR
Name : BARBARA GALINDO
Credential :
Telephone Number : 305-267-2700
Provider Enumeration Date : 10/24/2011
Last Update Date : 10/24/2011

Similar Medicare Providers

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1861580359 — PINES REHABILITATION INC
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1558556480 — DANIEL A CARPMAN MD M.D.
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1376541961 — DR. JORGE SANCHEZ-MASIQUES MD
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Directions to “RESIDENTIAL PLAZA AT BLUE LAGOON ” 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.

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