NPIMap

Organization Active NPI

Palmetto Living Facility, Inc.

  • Assisted Living Facility
  • Miami Lakes, FL
National Provider Identifier
1720101421
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10508 Issued in FL
Legal business name
PALMETTO LIVING FACILITY, INC.
Practice address
16350 N. W. 88 Path
Miami Lakes, FL 33018
Phone
(305) 300-6930
Fax
(305) 816-9996
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Vivian Bouza I
Title
Owner Administrator
Phone
(305) 300-6930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10508 FL Primary

Addresses

Primary practice location

16350 N. W. 88 Path
Miami Lakes, FL 33018

Mailing address

16350 N. W. 88 Path
Miami Lakes, FL 33018
Phone (305) 300-6930

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720101421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16350 N. W. 88 PATH",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33018",
            "telephone_number": "305-300-6930",
            "fax_number": "305-816-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16350 N. W. 88 PATH",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33018",
            "telephone_number": "305-300-6930",
            "fax_number": "305-816-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO LIVING FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUZA",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "305-300-6930",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.