Healthcare Provider Details

I. General information

NPI: 1023653565
Provider Name (Legal Business Name): LA VIDA ES BELLA ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SW 67TH AVE
MIAMI FL
33144-5514
US

IV. Provider business mailing address

1515 SW 67TH AVE
MIAMI FL
33144-5514
US

V. Phone/Fax

Practice location:
  • Phone: 786-353-9797
  • Fax: 786-409-7831
Mailing address:
  • Phone: 786-353-9797
  • Fax: 786-409-7831

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: ENID YASMIN BAZART
Title or Position: PRESIDENT
Credential:
Phone: 786-353-9797