Provider Demographics
NPI:1538922604
Name:FANTASTIC ADULT DAYCARE LLC
Entity type:Organization
Organization Name:FANTASTIC ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:FERREIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-239-2358
Mailing Address - Street 1:6878 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1704
Mailing Address - Country:US
Mailing Address - Phone:305-456-0407
Mailing Address - Fax:305-456-7398
Practice Address - Street 1:6878 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1704
Practice Address - Country:US
Practice Address - Phone:305-456-0407
Practice Address - Fax:305-456-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9590OtherAHCA