MEDICARE: VILLA MARGO V

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	AL9538	FL

General Provider Information

NPI Number	:	1811129943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLA MARGO V

Provider Business Mailing Address
First Line	:	3277 SW 22ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3109
Country	:	US
Telephone Number	:	305-858-1840
Fax Number	:	305-858-1840

Provider Business Practice Location Address
First Line	:	3277 SW 22ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3109
Country	:	US
Telephone Number	:	305-858-1840
Fax Number	:	305-858-1840

Authorized Official
Title or Position	:	V/PRESIDENT
Name	:	MARGARITA PILOTO
Credential	:
Telephone Number	:	305-858-1840

Provider Enumeration Date	:	08/24/2009
Last Update Date	:	08/24/2009

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