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NPI Code Detail

MEDICARE: PASSAGEWAY RESIDENCE OF DADE COUNTY

MEDICARE: PASSAGEWAY RESIDENCE OF DADE COUNTY
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
1251B00000XCase Management Agency8332FL

General Provider Information

NPI Number : 1952529455
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASSAGEWAY RESIDENCE OF DADE COUNTY
Provider Business Mailing Address
First Line : 2255 NW 10 TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33127-4219
Country : US
Telephone Number : 305-635-9106
Fax Number :
Provider Business Practice Location Address
First Line : 2255 NW 10TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33127-4219
Country : US
Telephone Number : 305-635-9106
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : THOMAS P MULLEN
Credential :
Telephone Number : 305-635-9106
Provider Enumeration Date : 04/23/2007
Last Update Date : 03/31/2026

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Directions to “PASSAGEWAY RESIDENCE OF DADE COUNTY ” Practice Location

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