Provider Demographics
NPI:1851977920
Name:VICTORIA NURSING LOVE ALF CORP.
Entity type:Organization
Organization Name:VICTORIA NURSING LOVE ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILAIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-443-6226
Mailing Address - Street 1:6890 SW 39TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3704
Mailing Address - Country:US
Mailing Address - Phone:786-332-3277
Mailing Address - Fax:305-603-9831
Practice Address - Street 1:6890 SW 39TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3704
Practice Address - Country:US
Practice Address - Phone:786-332-3277
Practice Address - Fax:305-603-9831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12325OtherAHCA