Organization
MARINA ASSISTED LIVING FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBERT DOMINGUEZ (OWNER)
(813) 956-2663
Entity
Organization
Contact information
Practice address
6702 W CLIFTON ST, TAMPA, FL 33634-5012
(813) 956-2663
(813) 882-0241
Mailing address
6702 W CLIFTON ST, TAMPA, FL 33634-5012
(813) 956-2663
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11199
FL
Other
Enumeration date
02/04/2014
Last updated
02/05/2014
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