Healthcare Provider Details

I. General information

NPI: 1699307900
Provider Name (Legal Business Name): SILVER YEARS HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 W FLAGLER ST STE 214
MIAMI FL
33174-1183
US

IV. Provider business mailing address

11200 W FLAGLER ST STE 214
MIAMI FL
33174-1183
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-2367
  • Fax: 305-675-0276
Mailing address:
  • Phone: 305-223-2367
  • Fax: 305-675-0276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENISE MARESMA
Title or Position: ADMINITRATOR
Credential:
Phone: 305-984-9773