Organization
NANCY PAULINE
Active
Other names
Villa Serena
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A LOOMIS (ADMINISTRATOR)
(813) 855-7241
Entity
Organization
Contact information
Practice address
6003 AMBASSADOR DR, TAMPA, FL 33615-3435
(813) 886-0481
(813) 925-3825
Mailing address
6003 AMBASSADOR DR, TAMPA, FL 33615-3435
(813) 886-0481
(813) 925-3825
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8056
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140090800
—
FL
Enumeration date
10/14/2011
Last updated
10/14/2011
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