Healthcare Provider Details

I. General information

NPI: 1174882518
Provider Name (Legal Business Name): SWEET LIFE ADULT DAY CARE, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 S.W. 72 ST. STE #412
MIAMI FL
33173
US

IV. Provider business mailing address

10300 S.W. 72 ST. STE #412
MIAMI FL
33173
US

V. Phone/Fax

Practice location:
  • Phone: 786-554-9485
  • Fax: 305-639-8920
Mailing address:
  • Phone: 786-554-9485
  • Fax: 305-639-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9187
License Number StateFL

VIII. Authorized Official

Name: MRS. LISSETTE LIMA
Title or Position: OWNER/ADMIN
Credential:
Phone: 786-554-9485