Organization
BAMBOO VILLAS ASSITED LIVING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODOLFO SUMULONG (OWNER)
(813) 766-4018
Entity
Organization
Contact information
Practice address
2730 W WILDER AVE, TAMPA, FL 33614-6809
(813) 766-4018
Mailing address
2730 W WILDER AVE, TAMPA, FL 33614-6809
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11420
FL
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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