MEDICARE: ANORANZA DE MI VIEJO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QA0600X	Adult Day Care Clinic/Center
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1003447871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANORANZA DE MI VIEJO INC

Provider Business Mailing Address
First Line	:	1849 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	954-225-0199
Fax Number	:

Provider Business Practice Location Address
First Line	:	1849 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	786-278-7190
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YORDAN SENAN BENITEZ
Credential	:
Telephone Number	:	954-225-0199

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	03/20/2023

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