Old Dominium, Inc

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL11130 Issued in FL

Legal business name

OLD DOMINIUM, INC

Practice address

9820 SW 72ND St
Miami, FL 33173-4618

Phone

(305) 219-9445

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Jorge Luis Sosa

Title

Administrator

Phone

(305) 219-9445

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1497934954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331734618",
            "telephone_number": "305-219-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331734618",
            "telephone_number": "305-219-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD DOMINIUM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "SOSA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-219-9445"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL11130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlene Olazabal, MS
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• Gabriel Olazarra Blanco
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• Old Medical Supplies, Inc.
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• Oldin Pharmacy Inc
• Melissa Morris Olen, ARNP
• Oleo NP Service LLC

• Assisted Living Facility (Mental Illness) in Miami, FL
• Providers in Miami, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.