Provider Demographics
NPI:1720735376
Name:ST DB&Y HOME FOR THE ELDERLY INC
Entity Type:Organization
Organization Name:ST DB&Y HOME FOR THE ELDERLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-828-2003
Mailing Address - Street 1:8715 NW 153RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1356
Mailing Address - Country:US
Mailing Address - Phone:305-828-2003
Mailing Address - Fax:
Practice Address - Street 1:8715 NW 153RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-1356
Practice Address - Country:US
Practice Address - Phone:305-828-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142546300Medicaid