Healthcare Provider Details

I. General information

NPI: 1972906204
Provider Name (Legal Business Name): MIAMI-DADE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26063 S DIXIE HWY
HOMESTEAD FL
33032-6613
US

IV. Provider business mailing address

26063 S DIXIE HWY
HOMESTEAD FL
33032-6613
US

V. Phone/Fax

Practice location:
  • Phone: 305-972-2198
  • Fax:
Mailing address:
  • Phone: 305-972-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9236
License Number StateFL

VIII. Authorized Official

Name: ROCELISMA MESA
Title or Position: OWNER
Credential:
Phone: 305-972-2198