Healthcare Provider Details

I. General information

NPI: 1285842021
Provider Name (Legal Business Name): CARY'S ADULT CARE II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15765 SW 76TH TER
MIAMI FL
33193-2901
US

IV. Provider business mailing address

15765 SW 76TH TER
MIAMI FL
33193-2901
US

V. Phone/Fax

Practice location:
  • Phone: 786-486-9365
  • Fax: 305-225-1289
Mailing address:
  • Phone: 786-486-9365
  • Fax: 305-225-1289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL 10796
License Number StateFL

VIII. Authorized Official

Name: MARCOS MOLINA
Title or Position: OWNER
Credential:
Phone: 786-486-9365