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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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