MEDICARE: CORAL GABLES ALF NETWORK INC

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		FL

General Provider Information

NPI Number	:	1598913303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL GABLES ALF NETWORK INC

Provider Business Mailing Address
First Line	:	PO BOX 140151
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33114-0151
Country	:	US
Telephone Number	:	305-300-9241
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 S LE JEUNE RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4252
Country	:	US
Telephone Number	:	305-300-9241
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. BLANCA VAZQUEZ
Credential	:
Telephone Number	:	305-300-9241

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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