MEDICARE: THE GARDEN OF EDEN 2025, CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1407703523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GARDEN OF EDEN 2025, CORP

Provider Business Mailing Address
First Line	:	4224 CLEVELAND AVE STE 7
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9051
Country	:	US
Telephone Number	:	786-344-0926
Fax Number	:	786-703-2137

Provider Business Practice Location Address
First Line	:	4224 CLEVELAND AVE STE 7
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9051
Country	:	US
Telephone Number	:	786-344-0926
Fax Number	:	786-703-2137

Authorized Official
Title or Position	:	CEO
Name	:	YAIMA MARTIN
Credential	:
Telephone Number	:	786-344-0926

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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