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Organization
SUN COAST VILLAGE I
Active
Organization
SUN COAST VILLAGE I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL BANEGAS (OWNER)
(305) 228-6517
Entity
Organization
Contact information
Practice address
12785 SW 49TH TER, MIAMI, FL 33175-5401
(305) 228-6517
(305) 225-1289
Mailing address
12785 SW 49TH TER, MIAMI, FL 33175-5401
(305) 228-6517
(305) 225-1289
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7920
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141274400
—
FL
Enumeration date
09/05/2007
Last updated
09/05/2007
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