Provider Demographics
NPI:1689882821
Name:LOS ABUELITOS FELICES II
Entity Type:Organization
Organization Name:LOS ABUELITOS FELICES II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-254-4098
Mailing Address - Street 1:14743 SW 173RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1798
Mailing Address - Country:US
Mailing Address - Phone:305-254-4098
Mailing Address - Fax:305-225-1289
Practice Address - Street 1:14743 SW 173RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-1798
Practice Address - Country:US
Practice Address - Phone:305-254-4098
Practice Address - Fax:305-225-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 10820310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility