Healthcare Provider Details

I. General information

NPI: 1477310845
Provider Name (Legal Business Name): ALLY CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 03/04/2024
Certification Date: 03/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21548 SW 89TH PATH
CUTLER BAY FL
33189-7353
US

IV. Provider business mailing address

21548 SW 89TH PATH
CUTLER BAY FL
33189-7353
US

V. Phone/Fax

Practice location:
  • Phone: 786-732-6193
  • Fax: 786-732-6190
Mailing address:
  • Phone: 786-732-6193
  • Fax: 786-732-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: WANDA YVETTE LARACUENTE
Title or Position: ADMINISTRATION
Credential:
Phone: 786-732-6193