Healthcare Provider Details

I. General information

NPI: 1659095982
Provider Name (Legal Business Name): LIVE IT UP ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 NW 95TH ST STE 341
HIALEAH GARDENS FL
33016-2361
US

IV. Provider business mailing address

8040 NW 95TH ST STE 341
HIALEAH GARDENS FL
33016-2361
US

V. Phone/Fax

Practice location:
  • Phone: 786-317-1616
  • Fax:
Mailing address:
  • Phone: 786-317-1616
  • Fax:

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: ANABEL PEDRAJA
Title or Position: OWNER
Credential:
Phone: 786-317-1616