=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689312985
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANJOLE ACADEMY PPEC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2022
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2555 NW 102ND AVE STE 202
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-2131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-564-8557
-----------------------------------------------------
Fax | 305-564-8559
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2555 NW 102ND AVE STE 202
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-2131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-564-8557
-----------------------------------------------------
Fax | 305-564-8559
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LEIDY ABAD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-527-4341
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3140N1450X
-----------------------------------------------------
Taxonomy Name | Pediatric Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------