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General NPI Number Information
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NPI Number | 1457638611
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Entity Type | Organization
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Legal Business Name | LA EDAD DE ORO ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 5870 S.W. 8TH STREET STE 8
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-262-2700
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Fax | 305-262-0189
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Provider Business Mailing Address
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Address Line | 5870 S.W. 8TH STREET STE 8
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-262-2700
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Fax | 305-262-0189
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Authorized Official
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Title or Position | OWNER
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Name | MIRVIAN RODRIGUEZ
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Credential |
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Telephone | 305-467-6851
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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 | 9127
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License Number State | FL
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