MEDICARE: GALAAD ALF 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1912549296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALAAD ALF CORP

Provider Business Mailing Address
First Line	:	7508 CLEARVIEW DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2930
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7508 CLEARVIEW DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2930
Country	:	US
Telephone Number	:	813-313-7183
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARLOS E MARTINEZ
Credential	:
Telephone Number	:	813-313-7183

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	10/08/2019

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Directions to “GALAAD ALF CORP ” Practice Location

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