Healthcare Provider Details

I. General information

NPI: 1972479871
Provider Name (Legal Business Name): NUEVO AMANECER CARE CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 SW 28TH ST
MIAMI FL
33133-2834
US

IV. Provider business mailing address

3375 SW 28TH ST
MIAMI FL
33133-2834
US

V. Phone/Fax

Practice location:
  • Phone: 786-541-4787
  • Fax:
Mailing address:
  • Phone: 786-541-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAVEL ALEJANDRO BETANCOURT CARDENAS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 786-541-4787