Organization
AZUCAR ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISSETTE GANCEDO (ADMINISTRATOR)
(305) 815-8367
Entity
Organization
Contact information
Practice address
8655 SW 24TH ST, SUITE C, MIAMI, FL 33155-2337
(305) 815-8367
(305) 748-2544
Mailing address
8655 SW 24TH ST, SUITE C, MIAMI, FL 33155-2337
(305) 815-8367
(305) 748-2544
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
9235
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9235
AGENCY FOR HEALTH CARE ADMINISTRATION- DIVISION OF HEALTH QUALITY ASSURANCE
FL
Enumeration date
04/02/2013
Last updated
04/02/2013
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