=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548529225
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VILLA LA ESPERANZA III LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2012
-----------------------------------------------------
Last Update Date | 08/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8814 SLEEPY CREEK CT
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-333-2980
-----------------------------------------------------
Fax | 813-298-0268
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8814 SLEEPY CREEK CT
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33634-1128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-898-8017
-----------------------------------------------------
Fax | 813-898-8017
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. DEIBY JACINTO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-541-0093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | AL12114
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------