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General NPI Number Information
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NPI Number | 1962201418
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Entity Type | Organization
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Legal Business Name | FLETCHER FL AL LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 4100 E FLETCHER AVE
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City | TAMPA
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State | FL
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Zip | 33613-4864
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Country | US
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Telephone | 646-290-1489
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Fax |
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Provider Business Mailing Address
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Address Line | 16690 COLLINS AVE STE 804
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-5685
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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 | CFO
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Name | BINYOMIN FRIED
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Credential |
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Telephone | 646-290-1489
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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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