Provider Demographics
NPI:1952512758
Name:ANGEL ALF
Entity Type:Organization
Organization Name:ANGEL ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-539-6851
Mailing Address - Street 1:9605 SW 144TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6941
Mailing Address - Country:US
Mailing Address - Phone:786-539-6851
Mailing Address - Fax:305-382-2353
Practice Address - Street 1:9605 SW 144TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6941
Practice Address - Country:US
Practice Address - Phone:786-539-6851
Practice Address - Fax:305-382-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10045310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142593500Medicaid