Organization
GARDENS OF TIME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA JULIA MEDINA RODRIGUEZ (MANAGER)
(813) 505-5564
Entity
Organization
Contact information
Practice address
4603 N SAINT VINCENT ST, TAMPA, FL 33614-6671
(813) 505-5564
(813) 443-0343
Mailing address
4603 N SAINT VINCENT ST, TAMPA, FL 33614-6671
(813) 505-5564
(813) 443-0343
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
AL 12263
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006738700
—
FL
Enumeration date
01/30/2014
Last updated
01/30/2014
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