Provider Demographics
NPI:1972097046
Name:LA VIDA EN ROSA ADULT DAY CARE INC
Entity type:Organization
Organization Name:LA VIDA EN ROSA ADULT DAY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-382-4330
Mailing Address - Street 1:2433 SW 147TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4082
Mailing Address - Country:US
Mailing Address - Phone:305-551-6386
Mailing Address - Fax:305-551-6382
Practice Address - Street 1:2433 SW 147TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4082
Practice Address - Country:US
Practice Address - Phone:305-551-6386
Practice Address - Fax:305-551-6382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9421261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9421Medicaid