Buddy' S Place Mg Llc

NPI 1073800603 - Assisted Living Facility - 310400000X

NPI Details
NPI 1073800603
Enumeration Date 07/04/2011
Last Updated 07/04/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name REVILBRAY REVILBRAY
Position OWNER
Phone (305) 318-6593
Fax
Practice Location
5370 NW 172ND ST
MIAMI GARDENS FL, 33055-4062, US
Phone (305) 318-6593
Fax
Business Location
5370 NW 172ND ST
MIAMI GARDENS FL, 33055-4062, US
Phone (305) 318-6593
Fax
Toxanomy
Taxonomy Code 310400000X
License State Florida
License Number 11374
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According to our database, Buddy' S Place Mg Llc NPI is 1073800603, taxonomy code is 310400000X and license number is 11374, license state is located at Florida. Buddy' S Place Mg Llc physically located at 5370 Nw 172nd St, Miami Gardens FL, 33055-4062. NPI Number 1033115704 has the healthcare provider type.

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1073800603 NPI number is provided on an as is basis without warranty of any kind. 1073800603 is maintained by the National Plan & Provider Enumeration System. The contents of Buddy' S Place Mg Llc are for informational purposes only.