Healthcare Provider Details

I. General information

NPI: 1407703523
Provider Name (Legal Business Name): THE GARDEN OF EDEN 2025, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4224 CLEVELAND AVE STE 7
FORT MYERS FL
33901-9051
US

IV. Provider business mailing address

4224 CLEVELAND AVE STE 7
FORT MYERS FL
33901-9051
US

V. Phone/Fax

Practice location:
  • Phone: 786-344-0926
  • Fax: 786-703-2137
Mailing address:
  • Phone: 786-344-0926
  • Fax: 786-703-2137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YAIMA MARTIN
Title or Position: CEO
Credential:
Phone: 786-344-0926