Healthcare Provider Details

I. General information

NPI: 1588015192
Provider Name (Legal Business Name): EL PASEO SENIOR CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 NW 7TH ST 2ND FLOOR
MIAMI FL
33125-3704
US

IV. Provider business mailing address

1390 NW 7TH ST 2ND FLOOR
MIAMI FL
33125-3704
US

V. Phone/Fax

Practice location:
  • Phone: 786-655-0939
  • Fax: 786-580-5979
Mailing address:
  • Phone: 786-655-0939
  • Fax: 786-580-5979

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: MONICA K BARROS
Title or Position: CEO
Credential: RN
Phone: 786-655-0939