Provider Demographics
NPI:1679825608
Name:ADULT DAY CARE OF MIAMI BEACH, INC.
Entity Type:Organization
Organization Name:ADULT DAY CARE OF MIAMI BEACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-763-8548
Mailing Address - Street 1:1245 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3647
Mailing Address - Country:US
Mailing Address - Phone:305-763-8548
Mailing Address - Fax:
Practice Address - Street 1:1245 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3647
Practice Address - Country:US
Practice Address - Phone:305-763-8548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9216261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care