Healthcare Provider Details

I. General information

NPI: 1427980036
Provider Name (Legal Business Name): CENTURY GARDEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18140 NW 90TH AVE
HIALEAH FL
33018-6555
US

IV. Provider business mailing address

18140 NW 90TH AVE
HIALEAH FL
33018-6555
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-3889
  • Fax:
Mailing address:
  • Phone: 786-521-3889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH R CAIRO
Title or Position: PRESIDENT
Credential:
Phone: 786-521-3889