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NPI Code Detail

MEDICARE: FESTA ENTERPRISES INC.

MEDICARE: FESTA ENTERPRISES INC.
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
1310400000XAssisted Living Facility7353FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548507866
Entity Type Code : Organization
Provider Name (Legal Business Name) : FESTA ENTERPRISES INC.
Provider Business Mailing Address
First Line : 13860 LILY PAD CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1825
Country : US
Telephone Number : 239-565-3846
Fax Number : 239-481-9919
Provider Business Practice Location Address
First Line : 6722 WINKLER RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7204
Country : US
Telephone Number : 239-433-5553
Fax Number : 239-481-9919
Authorized Official
Title or Position : OWNER
Name : MRS. DOLORES J FESTA
Credential : ADMINISTRATOR
Telephone Number : 239-565-3846
Provider Enumeration Date : 01/07/2013
Last Update Date : 01/07/2013

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Directions to “FESTA ENTERPRISES INC. ” Practice Location

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