Provider Demographics
NPI:1861543803
Name:ACE ENDEAVORS LLC
Entity type:Organization
Organization Name:ACE ENDEAVORS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-635-0595
Mailing Address - Street 1:PO BOX 904
Mailing Address - Street 2:
Mailing Address - City:MANGO
Mailing Address - State:FL
Mailing Address - Zip Code:33550-0904
Mailing Address - Country:US
Mailing Address - Phone:813-635-0595
Mailing Address - Fax:813-635-0691
Practice Address - Street 1:3258 PARKSIDE CENTER CIRCLE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-0907
Practice Address - Country:US
Practice Address - Phone:813-635-0595
Practice Address - Fax:813-635-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8157Medicare ID - Type UnspecifiedPROVIDER NUMBER