MEDICARE: LAS MERCEDES ADULT DAY CARE V, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	9364	FL

General Provider Information

NPI Number	:	1255882304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS MERCEDES ADULT DAY CARE V, LLC

Provider Business Mailing Address
First Line	:	1619 NW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2139
Country	:	US
Telephone Number	:	305-400-9985
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 NW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2139
Country	:	US
Telephone Number	:	305-400-9985
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JORGE RAAD
Credential	:
Telephone Number	:	786-233-6981

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	06/30/2025

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