Healthcare Provider Details

I. General information

NPI: 1831665660
Provider Name (Legal Business Name): LAS MERCEDES ADULT DAY CARE V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11715 SW 147TH AVE
MIAMI FL
33196-3312
US

IV. Provider business mailing address

9839 SW 40TH ST
MIAMI FL
33165-3993
US

V. Phone/Fax

Practice location:
  • Phone: 786-233-6981
  • Fax:
Mailing address:
  • Phone: 786-233-6981
  • Fax:

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: JORGE RAAD
Title or Position: PRESIDENT
Credential:
Phone: 786-233-6981