Healthcare Provider Details

I. General information

NPI: 1891294625
Provider Name (Legal Business Name): MIAMI SENIOR ADULT DAY CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 W 42ND PL
HIALEAH FL
33012-5994
US

IV. Provider business mailing address

1630 W 72ND ST
HIALEAH FL
33014-4443
US

V. Phone/Fax

Practice location:
  • Phone: 786-525-1936
  • Fax: 305-822-9877
Mailing address:
  • Phone: 786-525-1936
  • 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: MRS. LILIANA CARBAJO-GARI
Title or Position: CEO/PRESIDENT
Credential:
Phone: 786-525-1936