M & K Group Home Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

M & K GROUP HOME INC

Doing business as

Matanzas Group Home

Practice address

4801 SW 201St Ter
SW Ranches, FL 33332-1007

Phone

(305) 333-2659

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Mario Cruz

Title

Owner

Phone

(786) 223-7751

Specialties & licenses 1

Addresses

Other names 1

• Matanzas Group Home Doing business as

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1962167312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 SW 201ST TER",
            "city": "SW RANCHES",
            "state": "FL",
            "postal_code": "333321007",
            "telephone_number": "305-333-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 SW 201ST TER",
            "city": "SW RANCHES",
            "state": "FL",
            "postal_code": "333321007",
            "telephone_number": "305-333-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & K GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-223-7751",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matanzas Group Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matanzas Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Freire, PT
• Ellen Garner, ARNP
• Danielle Yvonne Gentry, PT, DPT
• Sony Joseph
• Chris Keane
• Maria M Marco
• Steven Martin, PT
• Erica Lynn Panariello, APRN
• Liana Sarmiento, OTR/L
• Nuria Saurrales, APRN

• Developmental Disabilities Clinic/Center in SW Ranches, FL
• Providers in SW Ranches, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.