Organization
PROFESSIONAL ADVANCED ADULT DAY CARE,LLC
Active
Other names
The Senior Club
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO DOMINGUEZ RN (PRESIDENT)
(305) 456-9905
Entity
Organization
Contact information
Practice address
2668 SW 137TH AVE, MIAMI, FL 33175-6314
(305) 456-9905
(305) 846-9839
Mailing address
2668 SW 137TH AVE, MIAMI, FL 33175-6314
(305) 456-9905
(305) 846-9839
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
9206
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009571200
—
FL
05
—
012196500
—
FL
Enumeration date
03/26/2013
Last updated
07/15/2015
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