Provider Demographics
NPI:1669883039
Name:MY NEW OASIS, LLC.
Entity type:Organization
Organization Name:MY NEW OASIS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLREMO
Authorized Official - Middle Name:G
Authorized Official - Last Name:SOMEILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-202-3607
Mailing Address - Street 1:2640 SW 32ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2804
Mailing Address - Country:US
Mailing Address - Phone:305-202-3607
Mailing Address - Fax:
Practice Address - Street 1:2640 SW 32ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2804
Practice Address - Country:US
Practice Address - Phone:305-202-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12493310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility