Organization
CRYSTAL GEM MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE A HERNANDO (OWNER)
(305) 868-1830
Entity
Organization
Contact information
Practice address
10845 W GEM ST, CRYSTAL RIVER, FL 34428-6682
(352) 794-7601
Mailing address
300 71ST ST STE 410, MIAMI BEACH, FL 33141-3092
(305) 868-1830
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003517200
—
FL
Enumeration date
05/30/2013
Last updated
05/30/2013
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