Provider Demographics
NPI:1710574595
Name:SUN BAY MANOR INC
Entity Type:Organization
Organization Name:SUN BAY MANOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:REIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-807-2043
Mailing Address - Street 1:8820 SW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8063
Mailing Address - Country:US
Mailing Address - Phone:305-251-3080
Mailing Address - Fax:786-701-9626
Practice Address - Street 1:8820 SW 148TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-8063
Practice Address - Country:US
Practice Address - Phone:305-251-3080
Practice Address - Fax:786-701-9626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL7561OtherAHCA