Provider Demographics
NPI:1558568360
Name:JESUS DE NAZARETH CORP
Entity Type:Organization
Organization Name:JESUS DE NAZARETH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-635-0718
Mailing Address - Street 1:2030 N.W. 33 ST.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5490
Mailing Address - Country:US
Mailing Address - Phone:305-635-0718
Mailing Address - Fax:305-649-3222
Practice Address - Street 1:2030 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5490
Practice Address - Country:US
Practice Address - Phone:305-635-0718
Practice Address - Fax:305-649-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9215310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility