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General NPI Number Information
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NPI Number | 1518497130
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Entity Type | Organization
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Legal Business Name | PARADISE SENIOR CENTER INC
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6240 PEMBROKE RD
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City | MIRAMAR
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State | FL
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Zip | 33023
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Country | US
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Telephone | 954-732-7588
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Fax | 954-966-0320
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Provider Business Mailing Address
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Address Line | 6240 PEMBROKE RD
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City | MIRAMAR
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State | FL
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Zip | 33023-2216
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Country | US
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Telephone | 954-732-7588
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Fax | 954-966-0320
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NORMA SAN JUAN
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Credential |
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Telephone | 954-732-7588
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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 | 9390
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License Number State | FL
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