Palms of Lauderdale Lakes the LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1098096 Issued in FL

Legal business name

PALMS OF LAUDERDALE LAKES THE LLC

Practice address

3370 NW 47TH Ter
Lauderdale Lakes, FL 33319-6701

Phone

(954) 733-0655

Fax

(954) 733-1521

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Tzvi Bogomilsky

Title

Authorized Member

Phone

(305) 401-7901

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Palms Rehabilitation and Nursing Center Doing business as

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1811042286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NE MIAMI GARDENS DR",
            "address_2": "#368",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331795035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 NW 47TH TER",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333196701",
            "telephone_number": "954-733-0655",
            "fax_number": "954-733-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMS OF LAUDERDALE LAKES THE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "BOGOMILSKY",
        "authorized_official_first_name": "TZVI",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "305-401-7901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1098096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032153200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Palms Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis Antonio Paesano Alfaro, APRN
• Andres Palacio, MD
• Palms Facility Inc
• Palms Nursing and Rehab LLC
• Palms of Lauderdale Lakes
• Thomas Palumbo, RPH
• Kathrin Ann Panos
• Nicole Pareja, M.A., BCBA
• Wyyetta Parham, RRT
• Dorota Paspalis, PTA

• Skilled Nursing Facility in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.