Provider Demographics
NPI:1215148259
Name:TWINS SENIOR RESIDENCE
Entity type:Organization
Organization Name:TWINS SENIOR RESIDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZELDA
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-559-6222
Mailing Address - Street 1:11334 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1104
Mailing Address - Country:US
Mailing Address - Phone:305-559-6222
Mailing Address - Fax:305-225-1289
Practice Address - Street 1:11334 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1104
Practice Address - Country:US
Practice Address - Phone:305-559-6222
Practice Address - Fax:305-225-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8322310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility