Healthcare Provider Details

I. General information

NPI: 1912759804
Provider Name (Legal Business Name): LIBERT ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 NW 54TH ST
MIAMI FL
33142-3857
US

IV. Provider business mailing address

1277 NW 54TH ST
MIAMI FL
33142-3857
US

V. Phone/Fax

Practice location:
  • Phone: 786-850-8401
  • Fax:
Mailing address:
  • Phone: 786-850-8401
  • 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: JULIO ALVAREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-850-8401