Provider Demographics
NPI:1275702748
Name:TROPICAL GARDEN VILLAS INC.
Entity Type:Organization
Organization Name:TROPICAL GARDEN VILLAS INC.
Other - Org Name:TROPICAL GARDEN VILLAS NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FITZROY
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-574-6954
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-1026
Mailing Address - Country:US
Mailing Address - Phone:561-383-2992
Mailing Address - Fax:561-383-2993
Practice Address - Street 1:420 CRESCENT CIR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2206
Practice Address - Country:US
Practice Address - Phone:561-574-6954
Practice Address - Fax:866-966-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL5553310400000X
FLAL7903310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112385800Medicaid