MEDICARE: BRITO'S HOME CORPORATION

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	AL11964	FL

General Provider Information

NPI Number	:	1891087235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRITO'S HOME CORPORATION

Provider Business Mailing Address
First Line	:	7361 PINE VALLEY DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2228
Country	:	US
Telephone Number	:	786-853-5569
Fax Number	:

Provider Business Practice Location Address
First Line	:	7361 PINE VALLEY DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2228
Country	:	US
Telephone Number	:	786-853-5569
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. VIRGINIA BRITO
Credential	:
Telephone Number	:	786-853-5569

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	05/04/2011

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Directions to “BRITO'S HOME CORPORATION ” Practice Location

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