Colonial Dr Senior Residence

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL 9970 Issued in FL

Legal business name

COLONIAL DR SENIOR RESIDENCE

Practice address

10220 SW 164TH St
Miami, FL 33157-3167

Phone

(305) 554-9345

Fax

(305) 225-1289

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Odalys Govea

Title

Owner

Phone

(305) 554-9345

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902014756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SW 164TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573167",
            "telephone_number": "305-554-9345",
            "fax_number": "305-225-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 SW 164TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573167",
            "telephone_number": "305-554-9345",
            "fax_number": "305-225-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL DR SENIOR RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOVEA",
        "authorized_official_first_name": "ODALYS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-554-9345"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 9970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariela Colon
• Pablo Enrique Colon, MD
• Rebecca Maria Colon, PHARMD
• Santiago E Colon, DMD
• Yamila Colon, MSOT
• Colonial Home Health, Inc.
• Colonial Home Health, Inc.
• Colonial Medical Equipment Inc
• Colonial North Home Care
• Amanda Colonneaux, DDS

• 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 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.