Provider Demographics
NPI:1245703792
Name:SOUTH DADE OPCO LLC
Entity type:Organization
Organization Name:SOUTH DADE OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BENGIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-562-5501
Mailing Address - Street 1:945 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1733
Mailing Address - Country:US
Mailing Address - Phone:516-869-3700
Mailing Address - Fax:
Practice Address - Street 1:17475 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-5434
Practice Address - Country:US
Practice Address - Phone:305-255-1045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility