GENESIS ALF OF TAMPA MANAGEMENT GROUP CORP NPI 1417438854

NPI Information

  • NPI: 1417438854
  • Provider Name: GENESIS ALF OF TAMPA MANAGEMENT GROUP CORP
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 1108 BLACK KNIGHT DR
    VALRICO, FL
    ZIP 33594
  • Phone: (813) 530-0909

Map and Directions

Get Directions

NPI Details

GENESIS ALF OF TAMPA MANAGEMENT GROUP CORP is an assisted living facility in Valrico, FL. The provider is 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. GENESIS ALF OF TAMPA MANAGEMENT GROUP CORP NPI is 1417438854. The provider is registered as an organization entity type.

The provider's business location address is:

1108 BLACK KNIGHT DR
VALRICO, FL
ZIP 33594-800
Phone: (813) 530-0909

The provider's authorized official is Gladys Kanodereka .
The authorized official title is Administrator and has the following contact phone number (813) 330-8424.

The enumeration date for this NPI number is 8/23/2018 and was last updated on 8/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityAL12747FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AL12747OTHERFLORIDALICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI