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General NPI Number Information
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NPI Number | 1720511835
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Entity Type | Organization
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Legal Business Name | TRANQUILITY BAY ADULT DAY CARE OF MARATHON CORP.
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 10875 OVERSEAS HWY STE 130
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City | MARATHON
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State | FL
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Zip | 33050-3469
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Country | US
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Telephone | 786-452-2921
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Fax |
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Provider Business Mailing Address
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Address Line | 16321 SW. 53 TERR
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City | MIAMI
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State | FL
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Zip | 33185
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Country | US
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Telephone | 786-452-2921
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Fax |
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Authorized Official
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Title or Position | PRESIDENT.
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Name | MR. ROLANDO CRUZ
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Credential |
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Telephone | 305-586-3350
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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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