Plaza of Pembroke Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5120 Issued in FL

Legal business name

PLAZA OF PEMBROKE ALF LLC

Practice address

3535 SW 52ND Ave
Pembroke Park, FL 33023-5420

Phone

(954) 961-8111

NPI assigned

Sep 14, 2017

Organization subpart

No

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

Authorized official

Name

Zevi Kohn

Title

Member

Phone

(718) 338-2999

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1144749771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SW 52ND AVE",
            "city": "PEMBROKE PARK",
            "state": "FL",
            "postal_code": "330235420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SW 52ND AVE",
            "city": "PEMBROKE PARK",
            "state": "FL",
            "postal_code": "330235420",
            "telephone_number": "954-961-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA OF PEMBROKE ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "ZEVI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-338-2999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "5120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALF",
            "identifier": "5120",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Pembroke Park, FL
• Providers in Pembroke Park, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.