Healthcare Provider Details

I. General information

NPI: 1033923719
Provider Name (Legal Business Name): LAS MERCEDES ADULT DAY CARE V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 NW 57 ST
TAMARAC FL
33319
US

IV. Provider business mailing address

6650 NW 57 ST
TAMARAC FL
33319
US

V. Phone/Fax

Practice location:
  • Phone: 954-334-3120
  • Fax:
Mailing address:
  • Phone: 954-334-3120
  • Fax:

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: CLARA RIVAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-912-8595