MEDICARE: LIVEWELL OPERATIONS II 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	385H00000X	Respite Care	AL7169	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	:	1770906232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVEWELL OPERATIONS II INC

Provider Business Mailing Address
First Line	:	15520 NW 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6710
Country	:	US
Telephone Number	:	305-949-2626
Fax Number	:

Provider Business Practice Location Address
First Line	:	15520 NW 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6710
Country	:	US
Telephone Number	:	305-949-2626
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YANIR SHMARYOU
Credential	:
Telephone Number	:	305-949-2626

Provider Enumeration Date	:	02/03/2014
Last Update Date	:	02/03/2014

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Directions to “LIVEWELL OPERATIONS II INC ” Practice Location

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