Provider Demographics
NPI:1831941509
Name:DULCES MARIPOSAS ALF LLC
Entity type:Organization
Organization Name:DULCES MARIPOSAS ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:JOANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-338-1888
Mailing Address - Street 1:16925 SW 300TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3438
Mailing Address - Country:US
Mailing Address - Phone:305-242-0577
Mailing Address - Fax:786-429-1250
Practice Address - Street 1:16925 SW 300TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3438
Practice Address - Country:US
Practice Address - Phone:305-242-0577
Practice Address - Fax:786-429-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10734OtherAHCA