Healthcare Provider Details

I. General information

NPI: 1992552061
Provider Name (Legal Business Name): PENATE ADULT DAYCARE 6 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 NW 27TH AVE
MIAMI FL
33125-3016
US

IV. Provider business mailing address

8200 SW 117TH AVE STE 112
MIAMI FL
33183-4825
US

V. Phone/Fax

Practice location:
  • Phone: 786-550-7100
  • Fax:
Mailing address:
  • Phone: 305-904-9413
  • 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: CLARA PENATE
Title or Position: OWNER
Credential:
Phone: 305-458-4156