Healthcare Provider Details

I. General information

NPI: 1285538033
Provider Name (Legal Business Name): CARMITAS CARE III ASSISTED LIVING FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3552 N SYLVAN LN
MELBOURNE FL
32935-5737
US

IV. Provider business mailing address

3552 N SYLVAN LN
MELBOURNE FL
32935-5737
US

V. Phone/Fax

Practice location:
  • Phone: 407-797-9008
  • Fax:
Mailing address:
  • Phone: 407-797-9008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEJANDRA CLARK
Title or Position: OWNER
Credential:
Phone: 407-797-9008