Organization
LIZMARY SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS LUIS TALAVERA (PRESIDENT)
(305) 228-0972
Entity
Organization
Contact information
Practice address
16671 SW 52ND LN, MIAMI, FL 33185-5274
(305) 228-0972
(305) 228-0972
Mailing address
16671 SW 52ND LN, MIAMI, FL 33185-5274
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14005980
—
FL
05
—
14033422
—
FL
Enumeration date
06/30/2008
Last updated
07/17/2008
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