Provider Demographics
NPI:1669202081
Name:BERMUDEZ SENIOR CARE II INC
Entity type:Organization
Organization Name:BERMUDEZ SENIOR CARE II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYENCYS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-543-3467
Mailing Address - Street 1:14561 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6587
Mailing Address - Country:US
Mailing Address - Phone:786-543-3465
Mailing Address - Fax:
Practice Address - Street 1:14561 SW 30TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6587
Practice Address - Country:US
Practice Address - Phone:786-543-3465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility