Organization
FIESTA ADULT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA HEVIA (CEO)
(786) 204-2827
Entity
Organization
Contact information
Practice address
7816 NE 2ND AVE, MIAMI, FL 33138-4805
(786) 326-6331
Mailing address
18073 NW 74TH CT, HIALEAH, FL 33015-8455
(786) 326-6331
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L17000051182
AOI
—
Enumeration date
07/29/2020
Last updated
04/10/2023
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