Healthcare Provider Details

I. General information

NPI: 1972097046
Provider Name (Legal Business Name): LA VIDA EN ROSA ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 SW 147TH AVE
MIAMI FL
33185-4082
US

IV. Provider business mailing address

2433 SW 147TH AVE
MIAMI FL
33185-4082
US

V. Phone/Fax

Practice location:
  • Phone: 305-551-6386
  • Fax: 305-551-6382
Mailing address:
  • Phone: 305-551-6386
  • Fax: 305-551-6382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9421
License Number StateFL

VIII. Authorized Official

Name: MRS. ROSA PAIROT
Title or Position: VICE PRESIDENT/OPERATOR
Credential:
Phone: 786-382-4330