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General NPI Number Information
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NPI Number | 1063732808
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Entity Type | Organization
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Legal Business Name | BRI GARDENS
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 4838 WINDINGBROOK TRL
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7482
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Country | US
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Telephone | 813-994-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 4838 WINDINGBROOK TRL
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7482
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANDREA B DURAN
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Credential |
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Telephone | 813-994-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11702
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License Number State | FL
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