Healthcare Provider Details

I. General information

NPI: 1346593449
Provider Name (Legal Business Name): ADULT DAY CENTER OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9855 SW 184TH ST
PALMETTO BAY FL
33157-6934
US

IV. Provider business mailing address

9855 SW 184TH ST
PALMETTO BAY FL
33157-6934
US

V. Phone/Fax

Practice location:
  • Phone: 305-975-2797
  • Fax:
Mailing address:
  • Phone: 305-975-2797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9218
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. ELAINE ORTIZ
Title or Position: OWNER
Credential:
Phone: 305-975-2797