- Enrollment id
- O20080207000423
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1104922715
- Multiple npi flag
- N
- Ccn
- 105449
- Associate id
- 2860575339
- Organization name
- DOS OF NORTH SHORE LTD
- Doing business as name
- MIAMI SHORES NURSING AND REHAB CENTER
- Incorporation date
- 1998-06-04
- Incorporation state
- FL
- Organization type structure
- PARTNERSHIP
- Proprietary nonprofit
- P
- Nursing home provider name
- MIAMI SHORES NURSING AND REHAB CENTER
- Address line 1
- 9380 NW 7TH AVE
- City
- MIAMI
- State
- FL
- Zip code
- 331502012