| Organization Name: | LA EDAD DE ORO ADULT DAY CARE, LLC |
| NPI Number: | 1457638611 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAIDELIN RAMONA LUGO (OWNER) |
| Mailing Address: | 5870 Sw 8th St Suite 8 West Miami |
| State: | FL US |
| Postal Code: | 331445052 |
| Phone Number: | 7862754628 |
| Fax Number: | 3052620189 |
| NPI Enumeration Date: | 11/15/2011 |
| NPI Last Update Date: | 11/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 9127 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |