Provider Demographics
NPI:1275888612
Name:FOTINE'S SENIOR HOME
Entity Type:Organization
Organization Name:FOTINE'S SENIOR HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCYS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-282-9229
Mailing Address - Street 1:5937 SW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5203
Mailing Address - Country:US
Mailing Address - Phone:305-661-3727
Mailing Address - Fax:
Practice Address - Street 1:5937 SW 41ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5203
Practice Address - Country:US
Practice Address - Phone:786-282-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility