MEDICARE: MARANGELI COLON, DAY-BY-DAY SUPPORT SERVICES

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1952809691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARANGELI COLON, DAY-BY-DAY SUPPORT SERVICES

Provider Business Mailing Address
First Line	:	6708 RIVERSIDE BLUFFS DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-4101
Country	:	US
Telephone Number	:	207-450-3156
Fax Number	:	813-324-8915

Provider Business Practice Location Address
First Line	:	6708 RIVERSIDE BLUFFS DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-4101
Country	:	US
Telephone Number	:	207-450-3156
Fax Number	:	813-324-8915

Authorized Official
Title or Position	:	OWNER
Name	:	MARANGELI COLON
Credential	:	CNA, B.S., A.A.
Telephone Number	:	813-324-8915

Provider Enumeration Date	:	01/29/2018
Last Update Date	:	01/29/2018

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