Healthcare Provider Details

I. General information

NPI: 1255882304
Provider Name (Legal Business Name): LAS MERCEDES ADULT DAY CARE V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 NW 27TH AVE
MIAMI FL
33125-2139
US

IV. Provider business mailing address

1619 NW 27TH AVE
MIAMI FL
33125-2139
US

V. Phone/Fax

Practice location:
  • Phone: 305-400-9985
  • Fax:
Mailing address:
  • Phone: 305-400-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9364
License Number StateFL

VIII. Authorized Official

Name: JORGE RAAD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 786-233-6981