MEDICARE: DIAMAR ADULT DAYCARE CENTER

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

General Provider Information

NPI Number	:	1841549888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAMAR ADULT DAYCARE CENTER

Provider Business Mailing Address
First Line	:	10989 SW 186TH ST
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-6812
Country	:	US
Telephone Number	:	305-256-9944
Fax Number	:	305-256-9955

Provider Business Practice Location Address
First Line	:	10989 SW 186TH ST # AT
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-6812
Country	:	US
Telephone Number	:	305-256-9944
Fax Number	:	305-256-9955

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DIANA REGO
Credential	:
Telephone Number	:	786-355-1394

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/06/2012

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