Provider Demographics
NPI:1134337090
Name:MARGREG FACILITIES CORP
Entity type:Organization
Organization Name:MARGREG FACILITIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:LOPEZ MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-759-8868
Mailing Address - Street 1:12412 SW 213 TERRACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5941
Mailing Address - Country:US
Mailing Address - Phone:305-259-8756
Mailing Address - Fax:786-453-2232
Practice Address - Street 1:12412 SW 213 TERRACE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5941
Practice Address - Country:US
Practice Address - Phone:305-259-8756
Practice Address - Fax:786-453-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10954310400000X
FL10954310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008821700Medicaid
FL142749100Medicaid