Healthcare Provider Details

I. General information

NPI: 1922794510
Provider Name (Legal Business Name): ADULT DAY CARE OF SUNRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 N UNIVERSITY DR
SUNRISE FL
33322-3936
US

IV. Provider business mailing address

2039 N UNIVERSITY DR
SUNRISE FL
33322-3936
US

V. Phone/Fax

Practice location:
  • Phone: 754-779-7630
  • Fax: 754-551-5503
Mailing address:
  • Phone: 754-779-7630
  • Fax: 754-551-5503

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: BRANDY GUZMAN
Title or Position: OWNER
Credential:
Phone: 305-587-6748