Provider Demographics
NPI:1700016862
Name:MIAMI GARDEN ALF, INC.
Entity Type:Organization
Organization Name:MIAMI GARDEN ALF, INC.
Other - Org Name:MIAMI GARDEN ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ONILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-620-1082
Mailing Address - Street 1:3520 NW 210TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-1255
Mailing Address - Country:US
Mailing Address - Phone:305-620-1082
Mailing Address - Fax:
Practice Address - Street 1:3520 NW 210TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1255
Practice Address - Country:US
Practice Address - Phone:305-620-1082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11085310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility