Organization
GUARDIAN HOME II ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLADYS FERNANDO RN (ADMINISTRATOR)
(386) 409-9456
Entity
Organization
Contact information
Practice address
902 CANAL ST., NEW SMYRNA BEACH, FL 32168
(386) 409-9455
(386) 409-9456
Mailing address
431 EAST AIRPORT BLVD., SANFORD, FL 32773-5494
(407) 323-2545
(407) 323-2545
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL55
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142656700
—
FL
Enumeration date
12/19/2007
Last updated
03/03/2009
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