Organization
INDIAN RIVER PARADISE LLC
Active
Other names
Banana River Paradise Villas
Organization subpart
No
Provider details
NPI number
Authorized official
MOSTAFA S HASSAN MD (PRESIDENT)
(914) 373-8098
Entity
Organization
Contact information
Practice address
1275 N BANANA RIVER DR, MERRITT ISLAND, FL 32952-5757
(914) 373-8098
Mailing address
2721 SE NORTH LOOKOUT BLVD, PORT SAINT LUCIE, FL 34984-6108
(914) 373-8098
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/19/2021
Last updated
09/19/2021
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