Organization
AVA CARES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER T DEROSA (ADMINISTRATOR)
(813) 300-6177
Entity
Organization
Contact information
Practice address
515 HICKORY LAKE DR, BRANDON, FL 33511-6337
(813) 300-6177
Mailing address
515 HICKORY LAKE DR, BRANDON, FL 33511-6337
(813) 300-6177
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL-12249
FL
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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