MEDICARE: CANITAS ADULT DAY CARE CENTER, 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	9426	FL

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	:	1598245052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANITAS ADULT DAY CARE CENTER, INC

Provider Business Mailing Address
First Line	:	1738 W 49TH ST STE 13-15
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3456
Country	:	US
Telephone Number	:	305-557-6545
Fax Number	:	305-557-6508

Provider Business Practice Location Address
First Line	:	1738 W 49TH ST STE 13-15
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3456
Country	:	US
Telephone Number	:	305-557-6545
Fax Number	:	305-557-6508

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OSIEL FIGUEREDO
Credential	:
Telephone Number	:	305-557-8007

Provider Enumeration Date	:	08/15/2018
Last Update Date	:	08/15/2018

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