Healthcare Provider Details

I. General information

NPI: 1013615210
Provider Name (Legal Business Name): BUENA VIDA ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E 41 ST
HIALEAH FL
33013
US

IV. Provider business mailing address

815 E 41 ST
HIALEAH FL
33013
US

V. Phone/Fax

Practice location:
  • Phone: 786-355-6464
  • Fax: 786-504-8932
Mailing address:
  • Phone: 786-355-6464
  • Fax: 786-504-8932

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: DAYANA MESA
Title or Position: OWNER
Credential:
Phone: 786-419-3604