Organization
FOUR MAGNOLIAS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YILIAM RODRIGUEZ (OWNER)
(305) 748-1047
Entity
Organization
Contact information
Practice address
21297 OLEAN BLVD STE A, PORT CHARLOTTE, FL 33952-6704
(941) 235-8226
(941) 235-8360
Mailing address
21297 OLEAN BLVD STE A, PORT CHARLOTTE, FL 33952-6704
(941) 235-8226
(941) 235-8360
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1288695
—
FL
Enumeration date
07/26/2025
Last updated
02/27/2026
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