Healthcare Provider Details

I. General information

NPI: 1780097865
Provider Name (Legal Business Name): J & C ADULT DAY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18505 NW 75TH PL SUITE #114
HIALEAH FL
33015-2961
US

IV. Provider business mailing address

18505 NW 75TH PL SUITE #114
HIALEAH FL
33015-2961
US

V. Phone/Fax

Practice location:
  • Phone: 305-202-3676
  • Fax: 305-675-0144
Mailing address:
  • Phone: 305-202-3676
  • Fax: 305-675-0144

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: ANTONIO MARRERO
Title or Position: OWNER
Credential:
Phone: 561-480-7557