Healthcare Provider Details

I. General information

NPI: 1396006441
Provider Name (Legal Business Name): PEQUENOS GIGANTES ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 SW 27TH AVE
MIAMI FL
33135-2901
US

IV. Provider business mailing address

311 SW 27TH AVE
MIAMI FL
33135-2901
US

V. Phone/Fax

Practice location:
  • Phone: 305-321-7588
  • Fax:
Mailing address:
  • Phone: 305-321-7588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9204
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. DAYANA M ARAUJO
Title or Position: OPERATOR
Credential:
Phone: 305-321-7588