Healthcare Provider Details

I. General information

NPI: 1194277251
Provider Name (Legal Business Name): GARDEN ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 NW 77TH CT STE 315
HIALEAH GARDENS FL
33016-2072
US

IV. Provider business mailing address

10550 NW 77TH CT STE 315
HIALEAH GARDENS FL
33016-2072
US

V. Phone/Fax

Practice location:
  • Phone: 305-992-5327
  • Fax:
Mailing address:
  • Phone: 305-992-5327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9363
License Number StateFL

VIII. Authorized Official

Name: MR. SERGIO GARCIA
Title or Position: OWNER
Credential:
Phone: 305-992-5327