Healthcare Provider Details

I. General information

NPI: 1649635319
Provider Name (Legal Business Name): ADULT DAY OF AVENTURA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 NE 207TH ST B-6-A
AVENTURA FL
33180-3771
US

IV. Provider business mailing address

3575 NE207 STREET B-6-A
AVENTURA FL
33180
US

V. Phone/Fax

Practice location:
  • Phone: 786-350-7002
  • Fax:
Mailing address:
  • Phone: 786-350-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SIGAL ADINYAYEV
Title or Position: PRESIDENT
Credential:
Phone: 786-350-7002