MEDICARE: ANITA'S SERVICES CORPORATION

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1689127805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANITA'S SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	17921 NW 48TH PL
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-3217
Country	:	US
Telephone Number	:	786-337-1406
Fax Number	:

Provider Business Practice Location Address
First Line	:	17921 NW 48TH PL
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-3217
Country	:	US
Telephone Number	:	786-337-1406
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANA CALZADA
Credential	:
Telephone Number	:	786-377-1406

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	07/25/2016

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