Coral Villa II Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10464 Issued in FL

Legal business name

CORAL VILLA II CORP

Practice address

14213 SW 100TH LN
Miami, FL 33186-6960

Phone

(305) 380-8084

Fax

(305) 252-1699

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Marcos Valdez

Title

Owner

Phone

(786) 972-5612

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1578774295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14213 SW 100TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866960",
            "telephone_number": "305-380-8084",
            "fax_number": "305-252-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14213 SW 100TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866960",
            "telephone_number": "305-380-8084",
            "fax_number": "305-252-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL VILLA II CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "VALDEZ",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-972-5612"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142178600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Coral Way Dental Associates Inc
• Coral Way Dental Center Inc
• Coral Way Diagnostic & Medical Services LLC
• Coral Way Diagnostic Services
• Coral Way Health Center Corp

• Assisted Living Facility in Miami, FL
• Providers in Miami, 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 Mar 15, 2023; 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.