Provider Demographics
NPI:1730960824
Name:SUENO DORADO AFL LLC
Entity type:Organization
Organization Name:SUENO DORADO AFL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWR
Authorized Official - Prefix:
Authorized Official - First Name:ALEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-785-1732
Mailing Address - Street 1:6903 PALM RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-3914
Mailing Address - Country:US
Mailing Address - Phone:813-785-1723
Mailing Address - Fax:813-302-9715
Practice Address - Street 1:6903 PALM RIVER RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3914
Practice Address - Country:US
Practice Address - Phone:813-785-1723
Practice Address - Fax:813-302-9715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility