Provider Demographics
NPI:1023485950
Name:ASSISTED LIVING OF FLORIDA LTD. INC.
Entity type:Organization
Organization Name:ASSISTED LIVING OF FLORIDA LTD. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SEMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-394-9624
Mailing Address - Street 1:10860 118TH ST
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3625
Mailing Address - Country:US
Mailing Address - Phone:727-394-9624
Mailing Address - Fax:
Practice Address - Street 1:11840 108TH CT
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-3616
Practice Address - Country:US
Practice Address - Phone:727-394-9624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5414-6-GA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL677629996Medicaid