MEDICARE: VILLA ROSA ASSISTED LIVING, 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

General Provider Information

NPI Number	:	1821977836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLA ROSA ASSISTED LIVING, CORP.

Provider Business Mailing Address
First Line	:	5890 SW 8TH ST
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-5036
Country	:	US
Telephone Number	:	305-266-0284
Fax Number	:

Provider Business Practice Location Address
First Line	:	5890 SW 8TH ST
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-5036
Country	:	US
Telephone Number	:	305-266-0284
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIANO PEREZ
Credential	:
Telephone Number	:	786-328-3844

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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