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General NPI Number Information
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NPI Number | 1740861723
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Entity Type | Organization
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Legal Business Name | A & C COMMUNITY SUPPORT LLC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2500 NW 79TH AVE STE 298
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City | DORAL
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State | FL
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Zip | 33122-1092
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Country | US
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Telephone | 305-939-7163
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 NW 79TH AVE STE 298
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City | MIAMI
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State | FL
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Zip | 33122-1092
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Country | US
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Telephone | 305-939-7163
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANE DARIAS
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Credential | RN BSN
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Telephone | 305-939-7163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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