Healthcare Provider Details

I. General information

NPI: 1972387751
Provider Name (Legal Business Name): DEL PRADO ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 DEL PRADO BLVD S
CAPE CORAL FL
33904-5750
US

IV. Provider business mailing address

2500 DEL PRADO BLVD S
CAPE CORAL FL
33904-5750
US

V. Phone/Fax

Practice location:
  • Phone: 239-318-4313
  • Fax: 239-772-1196
Mailing address:
  • Phone: 239-318-4313
  • Fax: 239-772-1196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DAISY MARTINEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 239-257-8572