Buddy'S Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

11626 Issued in FL

Legal business name

BUDDY'S PLACE, LLC

Practice address

229 Laurel Way
Miami Springs, FL 33166-5138

Phone

(305) 318-6593

NPI assigned

Jul 11, 2010

Organization subpart

No

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

Authorized official

Name

Revilbray Revilla

Title

Owner

Phone

(305) 318-6593

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1278806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278806400000",
    "number": "1689986242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 LAUREL WAY",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331665138",
            "telephone_number": "305-318-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 LAUREL WAY",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331665138",
            "telephone_number": "305-318-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUDDY'S PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-11",
        "last_updated": "2010-07-11",
        "status": "A",
        "authorized_official_last_name": "REVILLA",
        "authorized_official_first_name": "REVILBRAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-318-6593"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "11626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roselyn Bonilla, M.D.
• Jesus E Borges, CRT
• Lisandra Borges, LMT,BMO,CNA
• Leidys Lilie Bravo
• Stephanie Bruce, LCSW
• Buddy'S Place,LLC
• Patrica Burton, LMHC
• Barbara Liennys Cabrera Pereira, RBT
• Freddy J Caldera, M.D.
• Gladys Adialys Cancio Pascual

• Assisted Living Facility in Miami Springs, FL
• Providers in Miami Springs, 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 Jul 11, 2010; 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.