Healthcare Provider Details

I. General information

NPI: 1811772957
Provider Name (Legal Business Name): VIDA Y ALEGRIA ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14645 SW 42ND ST
MIAMI FL
33175-7825
US

IV. Provider business mailing address

14645 SW 42ND ST
MIAMI FL
33175-7825
US

V. Phone/Fax

Practice location:
  • Phone: 786-654-9820
  • Fax: 305-456-9985
Mailing address:
  • Phone: 786-654-9820
  • Fax: 305-456-9985

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: LUANDA CABRERA
Title or Position: OWNER
Credential:
Phone: 786-654-9820