Healthcare Provider Details

I. General information

NPI: 1962953455
Provider Name (Legal Business Name): MORNING STAR ADULT DAY CARE CENTER II CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13206 SW 8TH ST
MIAMI FL
33184-1176
US

IV. Provider business mailing address

13206 SW 8TH ST
MIAMI FL
33184-1176
US

V. Phone/Fax

Practice location:
  • Phone: 305-392-0899
  • Fax:
Mailing address:
  • Phone: 305-392-0899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9366
License Number StateFL

VIII. Authorized Official

Name: MS. PAULA MARIA RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-392-0899