Provider Demographics
NPI:1457742025
Name:MAYDEL ALF CORP
Entity Type:Organization
Organization Name:MAYDEL ALF CORP
Other - Org Name:MAYDEL ALF 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAYDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-748-7240
Mailing Address - Street 1:2006 W BARCLAY RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7544
Mailing Address - Country:US
Mailing Address - Phone:813-442-7601
Mailing Address - Fax:813-442-7601
Practice Address - Street 1:14910 N OLA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1615
Practice Address - Country:US
Practice Address - Phone:813-443-4296
Practice Address - Fax:813-443-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility