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General NPI Number Information
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NPI Number | 1033077557
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Entity Type | Organization
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Legal Business Name | LONGEVITY DAY CLUB AT MERRITT ISLAND LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3702 N COURTENAY PKWY
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-8194
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Country | US
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Telephone | 321-986-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 941 W MORSE BLVD STE 100
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City | WINTER PARK
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State | FL
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Zip | 32789-3781
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Country | US
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Telephone | 305-428-2480
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PILAR CARVAJAL
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Credential |
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Telephone | 305-428-2480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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