Provider Profile
INDEPENDENT LIVING SYSTEMS LLC
Health Care Clinic
FACILITY PROFILE
Street Address
- 4601 NW 77TH AVE
MIAMI, FL 33166-6449
County: Miami-Dade - Phone: (305) 262-1292
Mailing Address
- 4601 NW 77TH AVE
MIAMI, FL 33166-6449
County: Miami-Dade - Phone: (305) 262-1292
AHCA Reports
Inspection ReportsInspection Details
Facility Information:
| Facility/Provider Type: | Health Care Clinic | ||||||||||||||||||||||||
| Medical or Clinic Director: | Not Available | ||||||||||||||||||||||||
| Administrator: | HILDA MARIA PEREA | ||||||||||||||||||||||||
| Owner/Licensee: | INDEPENDENT LIVING SYSTEMS, LLC | ||||||||||||||||||||||||
| Owner/Licensee Since: | 8/27/2015 | ||||||||||||||||||||||||
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| Profit Status: | For-Profit | ||||||||||||||||||||||||
| Licensed Beds: | Not Available | ||||||||||||||||||||||||
| AHCA Number (File Number): | 11105 | ||||||||||||||||||||||||
| AHCA Field Office: | 11 | ||||||||||||||||||||||||
| License Number: | 10467 | ||||||||||||||||||||||||
| Current License Effective: | 1/6/2022 | ||||||||||||||||||||||||
| Current License Expires: | 1/5/2024 | ||||||||||||||||||||||||
| License Status: | LIC SURRENDER | ||||||||||||||||||||||||
Services/Characteristics
| Type: | Portable Equipment Provider |
Important information and facility/provider definitions can be found in the Glossary.
Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.