Provider Demographics
NPI:1720478001
Name:CORAL SAND INC
Entity Type:Organization
Organization Name:CORAL SAND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-978-0622
Mailing Address - Street 1:7800 ABBOTT AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2022
Mailing Address - Country:US
Mailing Address - Phone:305-867-3232
Mailing Address - Fax:305-867-9894
Practice Address - Street 1:7800 ABBOTT AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2022
Practice Address - Country:US
Practice Address - Phone:305-867-3232
Practice Address - Fax:305-867-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL93753104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142404100Medicaid