Healthcare Provider Details

I. General information

NPI: 1548978091
Provider Name (Legal Business Name): SMILING AND GROWING OLDER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13424 BISCAYNE BLVD
NORTH MIAMI FL
33181-2019
US

IV. Provider business mailing address

13424 BISCAYNE BLVD
NORTH MIAMI FL
33181-2019
US

V. Phone/Fax

Practice location:
  • Phone: 305-974-5990
  • Fax: 305-724-0238
Mailing address:
  • Phone: 305-974-5990
  • Fax: 305-724-0238

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: YAIMILYN ALONSO RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 786-537-2091