Provider Demographics
NPI:1013213586
Name:MIA CONSULTING GROUP, INC.
Entity Type:Organization
Organization Name:MIA CONSULTING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CONCEPCION
Authorized Official - Middle Name:TRELLES
Authorized Official - Last Name:BRETOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-864-4248
Mailing Address - Street 1:5208 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2005
Mailing Address - Country:US
Mailing Address - Phone:187-786-4424
Mailing Address - Fax:187-748-0880
Practice Address - Street 1:5208 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2005
Practice Address - Country:US
Practice Address - Phone:187-786-4424
Practice Address - Fax:187-748-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10314310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility