Provider Demographics
NPI:1093224578
Name:UNIVERSITY PLAZA REHABILITATION AND NURSING CENTER, INC.
Entity Type:Organization
Organization Name:UNIVERSITY PLAZA REHABILITATION AND NURSING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-917-0400
Mailing Address - Street 1:724 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1202
Mailing Address - Country:US
Mailing Address - Phone:305-325-2300
Mailing Address - Fax:
Practice Address - Street 1:724 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1202
Practice Address - Country:US
Practice Address - Phone:305-325-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEBREW HOMES HEALTH NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF130471053314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility