Healthcare Provider Details

I. General information

NPI: 1922529759
Provider Name (Legal Business Name): M & P LOVING ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2017
Last Update Date: 07/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 N ARMENIA AVE
TAMPA FL
33604-2759
US

IV. Provider business mailing address

2903 W SAINT CONRAD ST
TAMPA FL
33607-2922
US

V. Phone/Fax

Practice location:
  • Phone: 813-449-3877
  • Fax: 844-633-5300
Mailing address:
  • Phone: 813-449-3877
  • Fax: 844-633-5300

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: YAINES PERDOMO
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 813-449-3877