Organization
LOVING CARE OF ST PETERSBURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS JUAN MAZARIEGOS PHARMD (ADMINISTRATOR)
(727) 823-1625
Entity
Organization
Contact information
Practice address
1001 9TH ST N, ST PETERSBURG, FL 33701-1514
(727) 324-9963
Mailing address
1001 9TH ST N, ST PETERSBURG, FL 33701-1514
(727) 324-9963
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
11357
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000225800
—
FL
Enumeration date
07/10/2013
Last updated
07/10/2013
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