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Organization
ST MARY ADULT CARE
Active
Organization
ST MARY ADULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA L FERNANDEZ (OWNER)
(786) 393-8122
Entity
Organization
Contact information
Practice address
5716 SW 149TH PL, MIAMI, FL 33193-3011
(305) 408-0362
(305) 408-0362
Mailing address
PO BOX 771120, MIAMI, FL 33177-0019
(786) 393-8122
(305) 408-1263
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10555
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142286300
—
FL
05
—
689641300
—
FL
Enumeration date
07/14/2008
Last updated
02/19/2014
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