Residencia San Lazaro Home Care Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL 8454 Issued in FL

Legal business name

RESIDENCIA SAN LAZARO HOME CARE CORP

Practice address

7520 SW 92 Ave
Miami, FL 33173

Phone

(305) 598-2554

Fax

(305) 598-2554

NPI assigned

May 23, 2007

Reactivated

Dec 11, 2008

Organization subpart

No

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

Authorized official

Name

Elvira Rodriguez

Title

President

Phone

(305) 793-6523

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1770793846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 SW 92 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33173",
            "telephone_number": "305-598-2554",
            "fax_number": "305-598-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 SW 92 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33173",
            "telephone_number": "305-598-2554",
            "fax_number": "305-598-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENCIA SAN LAZARO HOME CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-12-11",
        "deactivation_date": "2008-06-04",
        "reactivation_date": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ELVIRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-793-6523"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 8454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140766000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680730500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Dec 11, 2008; 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.