Provider Demographics
NPI:1720511835
Name:TRANQUILITY BAY ADULT DAY CARE OF MARATHON CORP.
Entity Type:Organization
Organization Name:TRANQUILITY BAY ADULT DAY CARE OF MARATHON CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-586-3350
Mailing Address - Street 1:16321 SW. 53 TERR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185
Mailing Address - Country:US
Mailing Address - Phone:786-452-2921
Mailing Address - Fax:
Practice Address - Street 1:10875 OVERSEAS HWY
Practice Address - Street 2:STE 130
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3469
Practice Address - Country:US
Practice Address - Phone:786-452-2921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care