Provider Demographics
NPI:1578068615
Name:GARDENS OF TIME ADULT DAYCARE CORP
Entity Type:Organization
Organization Name:GARDENS OF TIME ADULT DAYCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-505-5564
Mailing Address - Street 1:7016 N DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5328
Mailing Address - Country:US
Mailing Address - Phone:813-505-5564
Mailing Address - Fax:813-433-5583
Practice Address - Street 1:7016 N DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5328
Practice Address - Country:US
Practice Address - Phone:813-505-5564
Practice Address - Fax:813-433-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care