Provider Demographics
NPI:1477949303
Name:PHOENIX PROGRAMS OF FLORIDA, INC. DBA PHOENIX HOUSES OF FLORIDA, INC.
Entity Type:Organization
Organization Name:PHOENIX PROGRAMS OF FLORIDA, INC. DBA PHOENIX HOUSES OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-881-1000
Mailing Address - Street 1:510 VONDERBURG DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5954
Mailing Address - Country:US
Mailing Address - Phone:813-881-1000
Mailing Address - Fax:
Practice Address - Street 1:5501 W WATERS AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1229
Practice Address - Country:US
Practice Address - Phone:813-881-1000
Practice Address - Fax:813-881-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1329AD294801261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder