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Organization

AMOEDO'S ALF

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HUGO A AMOEDO (OWNER)
(813) 781-1777
Entity
Organization

Contact information

Practice address
3415 W IVY ST, TAMPA, FL 33607-1502
(813) 842-3453
Mailing address
3415 W IVY ST, 3415 W IVY ST, TAMPA, FL 33607-1502
(813) 842-3453

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
AL 11149
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AL 11149
AGENCY FOR HEALTH CARE ADMINISTRATION
FL
Enumeration date
03/17/2011
Last updated
03/17/2011
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