=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841139219
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TUKA HOLDINGS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2026
-----------------------------------------------------
Last Update Date | 03/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3256 BENSON PARK BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32829-7329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-242-0352
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3256 BENSON PARK BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32829-7329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-242-0352
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | ANDRES RAFAEL VAZQUEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-242-0352
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------