MEMORY LANE COTTAGE AT OVIEDO, LLC (NPI# 1861917171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861917171 |
| Entity Type | Organization |
| Organization Name | MEMORY LANE COTTAGE AT OVIEDO, LLC |
| Practice Address |
450 Oviedo Blvd Oviedo FL 32765-3508 |
| Mailing Address |
999 Ponce De Leon Blvd Ste 950 Coral Gables FL 33134-3047 |
| Practice Telephone | 4073662770 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |
| Authorized Official Name | ROBERT J MATRAZZO (COO) |
| Authorized Official Telephone | 3054445007 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities |
| Street Address |
450 OVIEDO BLVD |
| City | OVIEDO |
| State | FL |
| Zip Code | 32765-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316576663 | Robby Hoffmann | Physical Therapist | 800 Red Bug Lake Road, Oviedo, FL 32765 | 2020-04-07 |
| 1366096836 | Brian Timothy Lowney | Pharmacist | 2871 Clayton Crossing Way #1001, Oviedo, FL 32765 | 2019-08-01 |
| 1083184634 | Ashley Grace Fuller | Speech-Language Pathologist | 251 Plaza Drive Suite C, Oviedo, FL 32765 | 2018-11-27 |
| 1164904678 | Katharine Albarella | Dietitian, Registered | 905 S. Lake Jessup Ave, Oviedo, FL 32765 | 2018-08-30 |
| 1871082396 | Catherine Victoria Wahl | Behavior Technician | 1350 San Remo Pt Apt 102, Oviedo, FL 32765 | 2018-05-10 |
| 1366943953 | Oviedo Smiles Dentistry, Pa | Dentist | 65 W. Mitchell Hammock Rd., Suite 1511, Oviedo, FL 32765 | 2018-02-28 |
| 1407385792 | Affordable Dentist | Dentist | 3228, W State Road 426, Suite 1000, Oviedo, FL 32765 | 2017-06-08 |
| 1104360221 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 658 Oviedo Medical Drive, Oviedo, FL 32765 | 2016-12-08 |
| 1174078281 | Dermatology and Skin Cancer Surgery Center, LLC | Dermatology | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765 | 2016-08-18 |
| 1780038463 | Matthew Christo | Counselor | 5076 Sugberry Trail, Oviedo, FL 32765 | 2016-04-19 |
| Find all providers in zip 32765 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316317423 | Lutheran Haven Extended Congregate Care, LLC | Alzheimer Center (Dementia Center) | 2035 W Sr 426, Oviedo, FL 32765-8524 | 2015-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527744 | Somh Boca Raton Operating, LLC | Alzheimer Center (Dementia Center) | 21865 Ponderosa Dr, Boca Raton, FL 33428-6215 | 2020-11-01 |
| 1417556978 | Mh Gentry Park Al Operating, LLC | Alzheimer Center (Dementia Center) | 3201 Center Pointe Dr, Orlando, FL 32825-6323 | 2020-10-25 |
| 1144876327 | Immaculate Adult Day Care LLC | Alzheimer Center (Dementia Center) | 234 Willard St Ste A, Cocoa, FL 32922-7984 | 2019-08-14 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1689152910 | American Eagle Leesburg Mc LLC | Alzheimer Center (Dementia Center) | 710 S Lake St, Leesburg, FL 34748-7327 | 2018-07-30 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1831640697 | Senior Living Iv Sun City, LLC | Alzheimer Center (Dementia Center) | 1320 33rd St Se, Ruskin, FL 33573-4904 | 2016-10-17 |
| 1881144699 | Mease Manor, Inc. | Alzheimer Center (Dementia Center) | 603 Virginia St, Dunedin, FL 34698-6613 | 2016-10-05 |
| Find all providers with the same taxonomy | ||||
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| 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.