Healthcare Provider Details

I. General information

NPI: 1053767525
Provider Name (Legal Business Name): HAPPY FAMILY ADULT DAY CARE, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16970 SAN CARLOS BLVD SUITE 120
FORT MYERS FL
33908
US

IV. Provider business mailing address

16970 SAN CARLOS BLVD SUITE 120
FORT MYERS FL
33908
US

V. Phone/Fax

Practice location:
  • Phone: 239-445-0567
  • Fax: 239-320-3237
Mailing address:
  • Phone: 239-445-0567
  • Fax: 239-320-3237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. YUDEY MIRANDA PEREDA
Title or Position: OWNER
Credential:
Phone: 239-821-9537