Provider Demographics
NPI:1861665218
Name:LA EDAD DE ORO, CUIDADO DE ANCIANOS
Entity Type:Organization
Organization Name:LA EDAD DE ORO, CUIDADO DE ANCIANOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:TERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-271-9080
Mailing Address - Street 1:9410 SW 52ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6408
Mailing Address - Country:US
Mailing Address - Phone:305-871-9080
Mailing Address - Fax:305-822-7479
Practice Address - Street 1:9410 SW 52ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-6408
Practice Address - Country:US
Practice Address - Phone:305-871-9080
Practice Address - Fax:305-822-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11228310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility