Healthcare Provider Details

I. General information

NPI: 1336462167
Provider Name (Legal Business Name): NONNAS ADULT DAY CARE FACILITY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8870 SW 40TH ST SUITE 5 AND 6
MIAMI FL
33165-5465
US

IV. Provider business mailing address

8870 SW 40TH ST SUITE 5 AND 6
MIAMI FL
33165-5465
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-8605
  • Fax: 305-397-2426
Mailing address:
  • Phone: 305-223-8605
  • Fax: 305-397-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ROSA MARIA SUAREZ
Title or Position: PRESIDENT
Credential: M.A., EMT
Phone: 305-223-8605