Provider Demographics
NPI:1447507504
Name:VEDADO FACILITY CARE INC
Entity type:Organization
Organization Name:VEDADO FACILITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-857-0558
Mailing Address - Street 1:2350 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2018
Mailing Address - Country:US
Mailing Address - Phone:305-857-0558
Mailing Address - Fax:
Practice Address - Street 1:2350 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2018
Practice Address - Country:US
Practice Address - Phone:305-857-0558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12222310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility