Organization
AMIGOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESUS PORBEN SR. (ADMINISTRATOR)
(305) 819-4626
Entity
Organization
Contact information
Practice address
5701 NW 110TH ST, HIALEAH, FL 33012-2566
(305) 819-4626
Mailing address
5701 NW 110TH ST, HIALEAH, FL 33012-2566
(305) 819-4626
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9906
FL
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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