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General NPI Number Information
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NPI Number | 1104217157
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Entity Type | Organization
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Legal Business Name | BROWARD ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 02/12/2015
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Provider Practice Location Address
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Address Line | 2615 DAVIE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-3029
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Country | US
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Telephone | 954-791-1611
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Fax | 954-688-2551
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Provider Business Mailing Address
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Address Line | 2615 DAVIE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-3029
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Country | US
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Telephone | 954-791-1611
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Fax | 954-688-2551
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABRAHAM ALONSO
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Credential |
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Telephone | 305-798-4535
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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 | FL
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