Organization
AVIEZRI HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GBEMISOLA OLATUNJI (OWNER)
(813) 416-3561
Entity
Organization
Contact information
Practice address
6137 MARSH TRAIL DR, ODESSA, FL 33556-4438
(813) 416-3561
Mailing address
6137 MARSH TRAIL DR, ODESSA, FL 33556-4438
(813) 416-3561
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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