Organization
MIGDALIA'S ACLF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAILEEN GONZALES (ADMINISTRATOR)
(813) 325-6906
Entity
Organization
Contact information
Practice address
2302 N LINCOLN AVE, TAMPA, FL 33607-3135
(813) 879-6980
(813) 879-8518
Mailing address
2302 N LINCOLN AVE, TAMPA, FL 33607-3135
(813) 879-6980
(813) 879-8518
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
006683
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007880700
—
FL
Enumeration date
06/04/2014
Last updated
06/04/2014
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