Provider Demographics
NPI:1407132517
Name:FLORIDA HOME CARE ALF II INC
Entity Type:Organization
Organization Name:FLORIDA HOME CARE ALF II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VPD
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUJOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-608-0706
Mailing Address - Street 1:15321 NW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-2403
Mailing Address - Country:US
Mailing Address - Phone:305-608-0706
Mailing Address - Fax:
Practice Address - Street 1:15321 NW 33RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-2403
Practice Address - Country:US
Practice Address - Phone:305-608-0706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL-12049310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility