Organization
MEDLEY SOCIAL CLUB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAYAMANTY PINO (OWNER)
(786) 781-2013
Entity
Organization
Contact information
Practice address
7911 NW 72ND AVE STE 108109, MEDLEY, FL 33166-2227
(786) 781-2013
(305) 887-1092
Mailing address
7911 NW 72ND AVE STE 108109, MEDLEY, FL 33166-2227
(786) 781-2013
(305) 887-1092
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9454
—
FL
Enumeration date
09/01/2020
Last updated
09/01/2020
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