Provider Demographics
NPI:1356615678
Name:DAISY CUIDADO DE ANCIANOS
Entity type:Organization
Organization Name:DAISY CUIDADO DE ANCIANOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-301-4849
Mailing Address - Street 1:6510 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4402
Mailing Address - Country:US
Mailing Address - Phone:305-301-4849
Mailing Address - Fax:
Practice Address - Street 1:6510 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4402
Practice Address - Country:US
Practice Address - Phone:305-301-4849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10011310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility