Provider Demographics
NPI:1831305440
Name:SANTOVENIA ADULT DAY CARE
Entity Type:Organization
Organization Name:SANTOVENIA ADULT DAY CARE
Other - Org Name:SANTOVENIA SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PERDOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-227-9500
Mailing Address - Street 1:13359 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3204
Mailing Address - Country:US
Mailing Address - Phone:305-227-9500
Mailing Address - Fax:
Practice Address - Street 1:13359 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3204
Practice Address - Country:US
Practice Address - Phone:305-227-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8891385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6002045OtherUNITED HEALTHCARE