Organization
CASA YBOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE GONZALEZ (ADMINISTRATOR)
(813) 486-2421
Entity
Organization
Contact information
Practice address
908 E 25TH AVE, TAMPA, FL 33605-1738
(813) 486-2421
(813) 402-2410
Mailing address
908 -E 25 TH AVE, TAMPA, FL 33605
(813) 486-2421
(813) 402-2410
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11705
FL
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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