Active NPI
Dos of North Shore LTD
- Skilled Nursing Facility
- Miami, FL
National Provider Identifier
1104922715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF1372096
- Legal business name
- DOS OF NORTH SHORE LTD
- Practice address
- 9380 NW 7TH Ave
Miami, FL 33150-2012 - Phone
- (305) 759-8711
- Fax
- (305) 757-8860
- NPI assigned
- Sep 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jorge R Hernando
- Title
- Owner
- Phone
- (305) 868-1830
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF1372096 | FL | Primary |
Addresses
Primary practice location
9380 NW 7TH Ave
Miami, FL 33150-2012
Mailing address
9380 NW 7TH Ave
Miami, FL 33150-2012
Phone (305) 759-8711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080207000423 | FL | Part A Provider - Skilled Nursing Facility | 2860575339 | Practice locations: Miami, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1104922715. Details of each certification follow.
Skilled nursing facility certification: CCN 105449
- Legal name
- DOS OF NORTH SHORE LTD
- Doing business as
- MIAMI SHORES NURSING AND REHAB CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 1, 1984
- Last certification
- Mar 26, 2025
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- Partnership
- Incorporated
- Jun 4, 1998 in FL
- Enrollment address
- 9380 NW 7TH Ave
Miami, FL 33150-2012 - Nursing home name
- MIAMI SHORES NURSING AND REHAB CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Miami Shores Nursing and Rehab Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 1, 1984
- Medicare certification status
- Active
- Certified beds
- 99
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0994273 | Dos of North Shores Nursing & Rehab Center | Certificate of waiver | Dec 9, 2027 |
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jorge Hernando | 5% Or Greater Direct Ownership Interest | Aug 4, 1998 | 27% |
| General Partnership Interest | Aug 4, 1998 | 27% | |
| Limited Partnership Interest | Jan 1, 2021 | 27% | |
| Corporate Director | Aug 4, 1998 | 27% | |
| Direct Ownership Interest | Aug 4, 1998 | 27% | |
| Jorge Hernando | 5% Or Greater Direct Ownership Interest | Aug 4, 1998 | 31% |
| General Partnership Interest | Aug 4, 1998 | 31% | |
| Limited Partnership Interest | Jan 1, 2021 | 31% | |
| Corporate Director | Aug 4, 1998 | 31% | |
| Direct Ownership Interest | Aug 4, 1998 | 31% | |
| Nick Antonacci | 5% Or Greater Direct Ownership Interest | Aug 4, 1998 | 19% |
| Limited Partnership Interest | Jan 1, 2021 | 19% | |
| Corporate Director | Aug 4, 1998 | 19% | |
| Direct Ownership Interest | Aug 4, 1998 | 19% | |
| Hamidreza Moghaddam | Adp of the SNF | Feb 13, 2025 | |
| Gladys K Hernando | 5% Or Greater Direct Ownership Interest | Jan 1, 2025 | 10% |
| Corporate Director | Jan 1, 2025 | 10% | |
| Marco a Carrasco | Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Feb 13, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202342400000",
"number": "1104922715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9380 NW 7TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331502012",
"telephone_number": "305-759-8711",
"fax_number": "305-757-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9380 NW 7TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331502012",
"telephone_number": "305-759-8711",
"fax_number": "305-757-8860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DOS OF NORTH SHORE LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-15",
"last_updated": "2008-02-07",
"status": "A",
"authorized_official_last_name": "HERNANDO",
"authorized_official_first_name": "JORGE",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "305-868-1830",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF1372096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.