Provider Demographics
NPI:1376503920
Name:SEFARDIK ASSOCIATES LLC
Entity Type:Organization
Organization Name:SEFARDIK ASSOCIATES LLC
Other - Org Name:THE NURSING CENTER AT MERCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:ESFORMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-854-1110
Mailing Address - Street 1:3671 S MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4253
Mailing Address - Country:US
Mailing Address - Phone:305-854-1110
Mailing Address - Fax:305-854-2827
Practice Address - Street 1:3671 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-854-1110
Practice Address - Fax:305-854-2827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1627096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105873Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER