Provider Demographics
NPI:1508242611
Name:THE PALACE MANAGEMENT GROUP, LLC.
Entity Type:Organization
Organization Name:THE PALACE MANAGEMENT GROUP, LLC.
Other - Org Name:THE PALACE CORAL GABLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ROIZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:305-270-7048
Mailing Address - Street 1:10850 SW 113TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3227
Mailing Address - Country:US
Mailing Address - Phone:786-270-2411
Mailing Address - Fax:
Practice Address - Street 1:1 ANDALUSIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6123
Practice Address - Country:US
Practice Address - Phone:786-270-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12411310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility