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General NPI Number Information
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NPI Number | 1932949633
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Entity Type | Organization
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Legal Business Name | 3 GARDENIAS ADULT DAY CENTER LLC
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 7902 W WATERS AVE STE G
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City | TAMPA
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State | FL
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Zip | 33615-1850
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Country | US
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Telephone | 813-939-5679
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Fax |
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Provider Business Mailing Address
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Address Line | 7902 W WATERS AVE STE G
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City | TAMPA
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State | FL
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Zip | 33615-1850
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Country | US
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Telephone | 813-290-7474
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Fax | 813-243-8924
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Authorized Official
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Title or Position | CEO
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Name | MRS. MARYLEYDIS LOPEZ ALVAREZ
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Credential |
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Telephone | 813-748-1704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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