Organization
MIRACLE ALF, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILAGRO LEAL (ADMINISTRATOR)
(813) 966-5335
Entity
Organization
Contact information
Practice address
8716 FOUNTAIN AVE, TAMPA, FL 33615-2802
(813) 966-5335
(813) 442-4704
Mailing address
8716 FOUNTAIN AVE, TAMPA, FL 33615-2802
(813) 966-5335
(813) 442-4704
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11704
FL
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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