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General NPI Number Information
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NPI Number | 1295136190
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Entity Type | Organization
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Legal Business Name | VALMAR ENTERPRISES
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 531 8TH ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-2110
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Country | US
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Telephone | 727-564-4956
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Fax |
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Provider Business Mailing Address
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Address Line | 531 8TH ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-2110
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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 | ADMINISTATOR
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Name | MR. DANIEL PARKS
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Credential |
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Telephone | 727-564-4956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL10728
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License Number State | FL
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