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General NPI Number Information
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NPI Number | 1073227047
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Entity Type | Organization
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Legal Business Name | EL COMEDOR ADULT DAY CARE CORP
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 8003 NW 95TH ST UNIT 2
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2378
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Country | US
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Telephone | 786-210-5484
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Fax |
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Provider Business Mailing Address
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Address Line | 26 E 57TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1234
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Country | US
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Telephone | 786-210-5484
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDY GONZALEZ
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Credential |
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Telephone | 786-351-5273
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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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