Organization
DOROTHY BODE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY D BODE (CEO)
(813) 986-2567
Entity
Organization
Contact information
Practice address
11930 FORT KING HWY, THONOTOSASSA, FL 33592-2804
(813) 986-2567
(813) 409-3729
Mailing address
11930 FORT KING HWY, THONOTOSASSA, FL 33592-2804
(813) 986-2567
(813) 409-3729
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010590700
—
FL
Enumeration date
09/25/2014
Last updated
09/25/2014
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