GUARDIAN ANGEL HEALTH SERVICES
Ambulatory Health at Himes Ave, Tampa, FL

License number
Florida 26QR0401X
Category
Ambulatory Health
Type
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Owner
Name: ALEXIS MACUYA
Title: OWNER.
Phone: (813) 877-5320
Address
Address
8011 N Himes Ave, Tampa, FL 33614
National Provider ID: 1619022100
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GUARDIAN ANGEL HEALTH SERVICES, INC

Tampa, FL  -  Miami, FL

Status:
Inactive
Inactive reason:
AMENDMENT
Registration:
Feb 28, 2005
Inactive since:
Mar 25, 2015
Addresses:
2309 W Dr.martin Luther King Jr Blvd 3, Tampa, FL 33607 (Physical)
3272 NW 72 Ave, Miami, FL 33122
2309 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607
State ID:
P05000030105
Business type:
Florida Profit Corporation
President, Treasurer, Director, Secretarys:
Macuya-Horta, Alexeis, 2309 W Dr.martin Luther King Jr Blvd, Tampa, FL 33607 (Physical),Alexeis Macuya-Horta (Secretary, President),Pedro A. Alvarez (Vice President),...
EIN:
20-2360244

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