Provider Demographics
NPI:1427433002
Name:DOUBLE NINE SENIORS CLUB II, INC.
Entity type:Organization
Organization Name:DOUBLE NINE SENIORS CLUB II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-775-7439
Mailing Address - Street 1:4670 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3907
Mailing Address - Country:US
Mailing Address - Phone:305-775-7439
Mailing Address - Fax:305-825-4454
Practice Address - Street 1:4670 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3907
Practice Address - Country:US
Practice Address - Phone:305-775-7439
Practice Address - Fax:305-825-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9324261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care