Organization
MADULYS ADULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL GONZALES (ADMINISTRATOR)
(305) 300-4898
Entity
Organization
Contact information
Practice address
15680 SW 139TH AVE, MIAMI, FL 33177-1067
(305) 300-4898
(305) 225-1289
Mailing address
15680 SW 139TH AVE, MIAMI, FL 33177-1067
(305) 300-4898
(305) 225-1289
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 10487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142223500
—
FL
Enumeration date
05/20/2007
Last updated
08/13/2008
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