Provider Demographics
NPI:1750741161
Name:VALDES RETIREMENT HOME II, INC.
Entity type:Organization
Organization Name:VALDES RETIREMENT HOME II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-312-9875
Mailing Address - Street 1:8240 SW 140TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4039
Mailing Address - Country:US
Mailing Address - Phone:305-380-1672
Mailing Address - Fax:305-380-1672
Practice Address - Street 1:8240 SW 140TH AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4039
Practice Address - Country:US
Practice Address - Phone:305-380-1672
Practice Address - Fax:305-380-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11264310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility