Organization
RESIDENCIA SAN LAZARO HOME CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIRA RODRIGUEZ (PRESIDENT)
(305) 793-6523
Entity
Organization
Contact information
Practice address
7520 SW 92 AVE, MIAMI, FL 33173
(305) 598-2554
(305) 598-2554
Mailing address
7520 SW 92 AVE, MIAMI, FL 33173
(305) 598-2554
(305) 598-2554
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 8454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140766000
—
FL
05
—
680730500
—
FL
Enumeration date
05/23/2007
Last updated
12/11/2008
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