MEDICARE: CAYMAN CIRCLE ADULT FAMILY CARE

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	310400000X	Assisted Living Facility	12609	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
2	12609	OTHER	FL	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710307079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAYMAN CIRCLE ADULT FAMILY CARE

Provider Business Mailing Address
First Line	:	5843 CAYMAN CIR W
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1853
Country	:	US
Telephone Number	:	561-512-8149
Fax Number	:

Provider Business Practice Location Address
First Line	:	5843 CAYMAN CIR W
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1853
Country	:	US
Telephone Number	:	561-512-8149
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DORRETT SCOTT
Credential	:
Telephone Number	:	561-512-8149

Provider Enumeration Date	:	04/24/2014
Last Update Date	:	09/07/2016

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Directions to “CAYMAN CIRCLE ADULT FAMILY CARE ” Practice Location

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