Provider Demographics
NPI:1568899086
Name:HILDA BENGOCHEA CORP
Entity Type:Organization
Organization Name:HILDA BENGOCHEA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONTIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-854-8744
Mailing Address - Street 1:335 SW 22ND RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1911
Mailing Address - Country:US
Mailing Address - Phone:305-854-8744
Mailing Address - Fax:
Practice Address - Street 1:335 SW 22ND RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1911
Practice Address - Country:US
Practice Address - Phone:305-854-8744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11631310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility