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General NPI Number Information
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NPI Number | 1124465190
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Entity Type | Organization
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Legal Business Name | DOLPHIN HOUSE ASSISTED LIVING FACILITY
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 9670 134TH STREET N.
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City | SEMINOLE
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State | FL
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Zip | 33776
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Country | US
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Telephone | 727-596-3266
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Fax | 727-596-3266
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Provider Business Mailing Address
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Address Line | 9670 134TH STREET N.
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City | SEMINOLE
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State | FL
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Zip | 33776
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Country | US
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Telephone | 727-596-3266
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Fax | 727-596-3266
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ROSAURO B. BALDERAMA
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Credential |
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Telephone | 727-596-3266
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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 | 8285
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License Number State | FL
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