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PARADISE RETIREMENT CLUB INC. NPI 1538479696


NPI Information

NPI: 1538479696
Provider Name: PARADISE RETIREMENT CLUB, INC.
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 10D2116806

Address:
21 SW 75TH AVE
MIAMI, FL
ZIP 33144
Phone: (305) 264-2051
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PARADISE RETIREMENT CLUB, INC. is an assisted living facility in Miami, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PARADISE RETIREMENT CLUB, INC. NPI is 1538479696. The provider is registered as an organization entity type.

The provider's business location address is:

21 SW 75TH AVE
MIAMI, FL
ZIP 33144-417
Phone: (305) 264-2051

The provider's authorized official is Irvin E Andujar .
The authorized official title is Administrator and has the following contact phone number (305) 264-2051.

The CLIA number assigned to this NPI record is 10D2116806 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/7/2010 and was last updated on 10/7/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityAL5902FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1140728700MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.