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General NPI Number Information
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NPI Number | 1164349213
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Entity Type | Organization
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Legal Business Name | MARAVIDA ORANGE CITY MGT LLC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 202 STRAWBERRY OAKS DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-7444
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Country | US
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Telephone | 386-878-4374
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Fax |
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Provider Business Mailing Address
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Address Line | 202 STRAWBERRY OAKS DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-7444
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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 | MANAGING MEMBER
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Name | ROBERTO CAREBETTA
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Credential |
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Telephone | 786-848-4414
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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 |
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License Number State |
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