Provider Demographics
NPI:1730464637
Name:ZURIEL ALF
Entity Type:Organization
Organization Name:ZURIEL ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKLENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:754-246-9475
Mailing Address - Street 1:6839 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5318
Mailing Address - Country:US
Mailing Address - Phone:954-317-3662
Mailing Address - Fax:954-317-3363
Practice Address - Street 1:6839 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-5318
Practice Address - Country:US
Practice Address - Phone:954-317-3662
Practice Address - Fax:954-317-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12031310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility