Provider Demographics
NPI:1184421158
Name:FENIX WELLNESS ADULT DAYCARE
Entity type:Organization
Organization Name:FENIX WELLNESS ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ADANYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO-ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-469-1722
Mailing Address - Street 1:9863 E FERN ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5413
Mailing Address - Country:US
Mailing Address - Phone:786-404-1008
Mailing Address - Fax:
Practice Address - Street 1:9863 E FERN ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5413
Practice Address - Country:US
Practice Address - Phone:786-404-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care