Organization
LOS ABUELOS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS HERNANDO PINZON RN (PRESIDENT)
(786) 234-6513
Entity
Organization
Contact information
Practice address
8901 SW 157TH AVE UNIT 10, MIAMI, FL 33196-1157
(305) 382-0111
(786) 955-2222
Mailing address
8901 SW 157TH AVE UNIT 10, MIAMI, FL 33196-1157
(305) 382-0111
(786) 955-2222
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AD12962297
AGENCY FOR THE HEALTH CARE ADMINISTRATION
FL
Enumeration date
07/19/2012
Last updated
07/19/2012
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