Organization
COLONIAL GARDENS RESIDENCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRVIAN RODRIGUEZ (OWNER)
(954) 484-1960
Entity
Organization
Contact information
Practice address
2801 NW 55TH AVE, LAUDERHILL, FL 33313-2509
(954) 484-1960
(954) 766-1657
Mailing address
2801 NW 55TH AVE, LAUDERHILL, FL 33313-2509
(954) 484-1960
(954) 766-1657
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7249
AHCA
FL
Enumeration date
04/02/2026
Last updated
04/02/2026
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