Provider Demographics
NPI:1811743222
Name:OCEAN BREEZE ALF LLC III
Entity type:Organization
Organization Name:OCEAN BREEZE ALF LLC III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:BREEZE ALF
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-767-7969
Mailing Address - Street 1:15707 PONY PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1529
Mailing Address - Country:US
Mailing Address - Phone:813-767-7969
Mailing Address - Fax:
Practice Address - Street 1:15707 PONY PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1529
Practice Address - Country:US
Practice Address - Phone:813-767-7969
Practice Address - Fax:813-243-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility