Healthcare Provider Details

I. General information

NPI: 1265984553
Provider Name (Legal Business Name): ROLA PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 39TH AVE
GAINESVILLE FL
32609-1902
US

IV. Provider business mailing address

3405 70TH GLN E
PALMETTO FL
34221-7386
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-3556
  • Fax:
Mailing address:
  • Phone: 352-505-3556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWIN ROBERTS
Title or Position: OWNER
Credential:
Phone: 352-505-3556