Healthcare Provider Details

I. General information

NPI: 1295183135
Provider Name (Legal Business Name): AMERICAN ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2342 VICTORIA FALLS DR
ORLANDO FL
32824-4314
US

IV. Provider business mailing address

2342 VICTORIA FALLS DR
ORLANDO FL
32824-4314
US

V. Phone/Fax

Practice location:
  • Phone: 407-963-5638
  • Fax: 407-278-4020
Mailing address:
  • Phone: 407-963-5638
  • Fax: 407-278-4020

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: O'NEIL PERALTA
Title or Position: MGR / OWNER
Credential: LPN
Phone: 407-963-5638