MEDICARE: CITY OF MIRAMAR

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	:	1912370446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF MIRAMAR

Provider Business Mailing Address
First Line	:	2300 CIVIC CENTER PLACE
Second Line	:	SOCIAL SERVICES DEPARTMENT/ADULT DAY CARE CENTER
City	:	MIRAMAR
State	:	FL
Zip	:	33025
Country	:	US
Telephone Number	:	954-889-2742
Fax Number	:	954-602-3677

Provider Business Practice Location Address
First Line	:	3081 TAFT ST
Second Line	:	ADULT DAY CARE CENTER
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-4461
Country	:	US
Telephone Number	:	954-505-4425
Fax Number	:	954-505-7733

Authorized Official
Title or Position	:	ASST DIRECTOR OF SOCIAL SERVICES
Name	:	MRS. JUSTINE HOO
Credential	:
Telephone Number	:	954-889-2742

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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Directions to “CITY OF MIRAMAR ” Practice Location

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