MEDICARE: ICARE ADULT DAY CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437618824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE ADULT DAY CARE INC.

Provider Business Mailing Address
First Line	:	7628 NW 186TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2929
Country	:	US
Telephone Number	:	305-530-8154
Fax Number	:	305-530-8156

Provider Business Practice Location Address
First Line	:	7628 NW 186TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2929
Country	:	US
Telephone Number	:	305-530-8154
Fax Number	:	305-530-8156

Authorized Official
Title or Position	:	OWNER
Name	:	ALBERTO J RODRIGUEZ SR.
Credential	:
Telephone Number	:	305-733-1818

Provider Enumeration Date	:	03/15/2019
Last Update Date	:	03/15/2019

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