FOUNTAIN OF YOUTH ALF INC (NPI# 1356753438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356753438 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN OF YOUTH ALF INC |
| Practice Address |
9001 Bana Villa Ct Tampa FL 33635 |
| Mailing Address |
9001 Bana Villa Ct Tampa FL 33635-1072 |
| Practice Telephone | 8138844166 |
| Mailing Telephone | 8138844166 |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2014-05-23 |
| Authorized Official Name | AMADA HERNANDEZ (OWNER) |
| Authorized Official Telephone | 8138844166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL9411 | FL | Nursing & Custodial Care Facilities |
| Street Address |
9001 BANA VILLA CT |
| City | TAMPA |
| State | FL |
| Zip Code | 33635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962927723 | Mobile Medical Care | Nurse Practitioner | 11671 Declaration Drive, Tampa, FL 33635 | 2017-08-13 |
| 1528428638 | Tracy Lee | Behavioral Analyst | 6951 Pistol Ridge Road, Tampa, FL 33635 | 2016-03-02 |
| 1912301409 | Stacey-ann Samuels Taylor | Contractor | 6608 Camden Bay Drive, # 303, Tampa, TAMPA 33635 | 2014-10-13 |
| 1518212646 | The Good Shepherd Sleep Center | Clinic/Center | 13668 W Hillsborough Ave, Tampa, FL 33635 | 2012-07-15 |
| 1033487343 | Crystal A Reinhart | Physical Therapist | 8417 Poydras Lane, Tampa, FL 33635 | 2011-12-01 |
| 1093002768 | Anthony Roosevelt Washington IIi | Family Medicine | 13608 W Hillsborough Ave, Tampa, FL 33635 | 2011-07-01 |
| 1710187778 | Jerome Abutal Abellana | Physical Therapist | 8504 Tidal Bay Ln, Tampa, FL 33635 | 2007-07-18 |
| 1902298433 | Cindy Ceja | Behavioral Analyst | 6951 Pistol Range Rd, Tampa, FL 33635 | 2015-02-20 |
| 1265842249 | Christine Ann Roeper | Technician, Other | 6951 Pistol Range Rd, Tampa, FL 33635 | 2014-04-30 |
| 1215496641 | Tampa Family Health Centers | Pharmacy | 12085 W. Hillsborough Ave., Tampa, FL 33635-0000 | 2019-03-15 |
| Find all providers in zip 33635 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704980 | Ocean Breeze Alf LLC | Assisted Living Facility | 4713 Kelly Rd, Tampa, FL 33615-5018 | 2020-09-14 |
| 1770191082 | Twala Neia Atwood | Assisted Living Facility | 3111 W Napoleon Ave, Tampa, FL 33611-5222 | 2020-07-22 |
| 1568080075 | Loving Health Care, Corp II | Assisted Living Facility | 4817 Ridge Point Dr, Tampa, FL 33624-6325 | 2020-07-10 |
| 1063036481 | La Rosa Alf Corp | Assisted Living Facility | 1615 Carnegie Cir, Tampa, FL 33619-5621 | 2020-06-01 |
| 1538783261 | L&y Paradise Alf Corp | Assisted Living Facility | 14314 Capitol Dr, Tampa, FL 33613-2116 | 2020-05-28 |
| 1205467107 | Bella Vita Alf At Latania LLC | Assisted Living Facility | 3413 Latania Dr, Tampa, FL 33618-4759 | 2020-01-29 |
| 1689213605 | Haven Alf, Inc. | Assisted Living Facility | 1514 Haven Bnd, Tampa, FL 33613-1133 | 2019-12-23 |
| 1194362491 | Sh Carrollwood, LLC | Assisted Living Facility | 13550 S Village Dr, Tampa, FL 33618-8420 | 2019-12-05 |
| 1235772062 | Bella Vita Assisted Living Community | Assisted Living Facility | 13202 Lake Magdalene Blvd, Tampa, FL 33618-3008 | 2019-10-24 |
| 1912549296 | Galaad Alf Corp | Assisted Living Facility | 7508 Clearview Dr, Tampa, FL 33634-2930 | 2019-10-08 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.