NPIMap

Organization Active NPI

Lago Place Inc

  • Assisted Living Facility
  • Miami, FL
National Provider Identifier
1053519231
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL9817 Issued in FL
Legal business name
LAGO PLACE INC
Practice address
10711 SW 52 Terrace
Miami, FL 33165-7037
Phone
(786) 534-8402
Fax
(786) 534-8402
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Saray Diaz
Title
Owner
Phone
(786) 314-0220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9817 FL Primary

Addresses

Primary practice location

10711 SW 52 Terrace
Miami, FL 33165-7037

Mailing address

10711 SW 52 Terrace
Miami, FL 33165-7037
Phone (786) 534-8402

Other identifiers 2

IdentifierTypeStateIssuer
140408300MedicaidFL
679164600MedicaidFL

Other names 1

  • ISABEL ADULT CARE INC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Isabel Adult Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1053519231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10711 SW 52 TERRACE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657037",
            "telephone_number": "786-534-8402",
            "fax_number": "786-534-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10711 SW 52 TERRACE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657037",
            "telephone_number": "786-534-8402",
            "fax_number": "786-534-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGO PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "SARAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-314-0220"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140408300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679164600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ISABEL ADULT CARE INC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "ISABEL ADULT CARE INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.