MS. GANIELLE MARVA PETERSON


Address: 2773 Se Clareton Ter, Port St Lucie, FL 34952-6621
Phone: 9546571812

MS. GANIELLE MARVA PETERSON (NPI# 1285241489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285241489
Entity Type Individual
Full Name MS. GANIELLE MARVA PETERSON
Credential ASSISTED LIVING ADMN
Practice Address 2773 Se Clareton Ter
Port St Lucie
FL 34952-6621
Practice Telephone 9546571812
Mailing Telephone 9546571812
Enumeration Date 2020-09-30
Last Update Date 2020-09-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 376G00000X Nursing Home Administrator FL Nursing Service Related Providers

Office Location

Street Address 2773 SE CLARETON TER
City PORT ST LUCIE
State FL
Zip Code 34952-6621

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NPI Name Taxonomy Address Enumeration
1215587068 Carehere LLC Family Medicine Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 2019-09-13
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1336611870 Med Braces and Supplies, LLC Durable Medical Equipment & Medical Supplies 1484 Se Village Green Dr, Port St Lucie, FL 34952 2018-12-21
1689143794 The Gift of Recovery, LLC Counselor 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 2018-11-19
1457830853 Cathy L Sonier Counselor 357 Brazilian Circle, Port St Lucie, FL 34952 2018-08-07
1548756661 Blo 7 Diabetes Institute Inc Nutritionist 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 2018-07-02
1780194464 Doctor's Choice Medical Center Clinic/Center 9164 S Us Highway 1, Port St Lucie, FL 34952 2017-10-06
1801305644 Thandiwe Daley Behavior Technician 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 2017-09-25
1700309408 Lagrand Evan Andrews Assistant Behavior Analyst 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 2017-07-25
1578085148 Lavetta S Ivey Behavior Technician 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 2017-07-14
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Taxonomy Information

Taxonomy Code 376G00000X
Grouping Nursing Service Related Providers
Classification Nursing Home Administrator

Taxonomy Definition

An individual, often licensed by the state, who is responsible for the management of a nursing home.
Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL, 1994, p. 552.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093284903 New Day Assisted Living, LLC Nursing Home Administrator 1931 Sw Mcallister Ln, Port St Lucie, FL 34953-2064 2018-11-20
1184807547 Cheryl Morgan Nursing Home Administrator 482 Sw Todd Ave, Port St Lucie, FL 34983-2914 2007-12-08
1619588357 Germine Lormera Nursing Home Administrator 1613 Sw Meridian Ave, Port St Lucie, FL 34953-4300 2020-08-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326652231 Emma Grace Homes LLC Nursing Home Administrator 600 Jefferis Ct, Eustis, FL 32726-5114 2020-09-08
1629692736 Michele M Gavin Nursing Home Administrator 3450 Kaiser Ave, Saint Cloud, FL 34772-7311 2020-06-04
1477188704 Ernie Tairon Lugo Nursing Home Administrator 5210 State Road N 33, Lot 8, Lakeland, FL 33805 2020-03-06
1073147914 Kemisha Latoya Mathis Nursing Home Administrator 2279 W 2nd St, Jacksonville, FL 32209-6906 2020-03-01
1174030589 Olivia Marcia Batchelor Nursing Home Administrator 1904 Gardner Ave, Lehigh Acres, FL 33936-5344 2018-01-08
1699212399 Ursula Schmiel-degama Nursing Home Administrator 11900 Nw 35th St, Sunrise, FL 33323-1242 2017-01-19
1578915070 Luz Medy Lebron Monclova Nursing Home Administrator 5681 Edenfield Rd, Apt. 1005, Jacksonville, FL 32277-1469 2016-07-07
1992157689 Marie Louis Nursing Home Administrator 19 Burning Wick Pl, Palm Coast, FL 32137-8802 2016-07-06
1326467374 Beverly Campbell Nursing Home Administrator 2808 S 10th St, Fort Pierce, FL 34982-4306 2014-04-07
1255777199 Vanessa Dugan Nursing Home Administrator 800 Lakewood Cir, Merritt Island, FL 32952-5886 2013-05-20
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Competitor

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City PORT ST LUCIE
Zip Code 34952

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Dataset Information

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.

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