Healthcare Provider Details

I. General information

NPI: 1013694918
Provider Name (Legal Business Name): RENACER 2 ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 W 29TH ST
HIALEAH FL
33012-5606
US

IV. Provider business mailing address

724 W 29TH ST
HIALEAH FL
33012-5606
US

V. Phone/Fax

Practice location:
  • Phone: 305-967-8948
  • Fax: 305-967-8329
Mailing address:
  • Phone: 305-967-8948
  • Fax: 305-967-8329

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: ROLANDO GARCIA CARRIO
Title or Position: OWNER
Credential:
Phone: 305-755-2980