Provider Demographics
NPI:1598945651
Name:CORAL GABLES HOLDINGS LLC
Entity Type:Organization
Organization Name:CORAL GABLES HOLDINGS LLC
Other - Org Name:CORAL GABLES NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-864-9191
Mailing Address - Street 1:7060 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4650
Mailing Address - Country:US
Mailing Address - Phone:305-261-1363
Mailing Address - Fax:
Practice Address - Street 1:7060 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4650
Practice Address - Country:US
Practice Address - Phone:305-261-1363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1103096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032377200Medicaid
FL032377200Medicaid