Healthcare Provider Details

I. General information

NPI: 1174455935
Provider Name (Legal Business Name): FLY DREAM & ENJOY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 SHIRLEY CT
LAKE WORTH BEACH FL
33461-6015
US

IV. Provider business mailing address

1422 SHIRLEY CT
LAKE WORTH BEACH FL
33461-6015
US

V. Phone/Fax

Practice location:
  • Phone: 561-307-5772
  • Fax: 561-868-6562
Mailing address:
  • Phone: 561-307-5772
  • Fax: 561-868-6562

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: YAMAY PEREZ
Title or Position: OWNER
Credential:
Phone: 561-307-5772