Healthcare Provider Details

I. General information

NPI: 1972042695
Provider Name (Legal Business Name): ABC-ALSY ADULT DAY CARE II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 SW 211TH ST
CUTLER BAY FL
33189-2845
US

IV. Provider business mailing address

248 NW 9TH AVE
HOMESTEAD FL
33030-5754
US

V. Phone/Fax

Practice location:
  • Phone: 305-242-5333
  • Fax: 305-242-5360
Mailing address:
  • Phone: 305-242-5333
  • Fax: 305-242-5360

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: DANIEL OROZCO
Title or Position: MRG
Credential:
Phone: 305-242-5333