Provider Demographics
NPI:1518431089
Name:ALIVIAR CARE OF WINTER PARK, LLC
Entity Type:Organization
Organization Name:ALIVIAR CARE OF WINTER PARK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-476-5577
Mailing Address - Street 1:320 W SABAL PALM PL STE 300
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3621
Mailing Address - Country:US
Mailing Address - Phone:407-830-1975
Mailing Address - Fax:
Practice Address - Street 1:495 N SEMORAN BLVD STE 9
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3802
Practice Address - Country:US
Practice Address - Phone:407-476-5577
Practice Address - Fax:407-641-9329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care