MEDICARE: AGING CARE CENTER INC

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	261QH0100X	Health Service Clinic/Center	1212604260	FL

General Provider Information

NPI Number	:	1649693730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGING CARE CENTER INC

Provider Business Mailing Address
First Line	:	15291 NW 60TH AVE
Second Line	:	104
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2458
Country	:	US
Telephone Number	:	305-698-8628
Fax Number	:	305-698-8629

Provider Business Practice Location Address
First Line	:	15291 NW 60TH AVE
Second Line	:	104
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2458
Country	:	US
Telephone Number	:	305-698-8628
Fax Number	:	305-698-8629

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TAMARA RODRIGUEZ
Credential	:
Telephone Number	:	305-389-4214

Provider Enumeration Date	:	01/27/2014
Last Update Date	:	01/27/2014

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Directions to “AGING CARE CENTER INC ” Practice Location

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