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General NPI Number Information
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NPI Number | 1710690789
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Entity Type | Organization
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Legal Business Name | TUCKER & TUCKER ALF
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 2703 N 29TH ST
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City | TAMPA
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State | FL
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Zip | 33605-3019
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Country | US
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Telephone | 813-701-4986
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 ALHAMBRA DR
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City | APOLLO BEACH
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State | FL
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Zip | 33572-2920
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Country | US
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Telephone | 813-999-5037
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROCHELLE TUCKER
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Credential |
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Telephone | 813-999-5037
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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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