IVAN MALDONADO (NPI# 1952714404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952714404 |
| Entity Type | Individual |
| Full Name | IVAN MALDONADO |
| Practice Address |
6320 Arlington Rd Jacksonville FL 32211-5430 |
| Practice Telephone | 9047439069 |
| Practice Fax Number | 9047433584 |
| Mailing Telephone | 9047439069 |
| Mailing Fax Number | 9047433584 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
AL8958 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 141157800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518963347 | Ivan L Maldonado | Surgery | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2005-06-27 |
| Street Address |
6320 ARLINGTON RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32211-5430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275941833 | Arlington Haven | Assisted Living Facility | 6320 Arlington Rd, Jacksonville, FL 32211-5430 | 2014-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1366089641 | Prophetic Healing Deliverance Ministry of Mysteries, Inc | Counselor | 8550-2 Lone Star Road, Jacksonville, FL 32211 | 2019-12-05 |
| 1922656370 | Timothy Richard Barron | Behavior Technician | 5633 Clifton Ln, Jacksonville, FL 32211 | 2019-08-29 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1902397276 | Chandra Harris Washington | In Home Supportive Care | 2712 Gaillardia Rd, Jacksonville, FL 32211 | 2018-05-22 |
| 1043730062 | Monica R Iskander | Dentist | 465 University Blvd N, Jacksonville, FL 32211 | 2017-06-21 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| Find all providers in zip 32211 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548826480 | Comfort Alf LLC | Assisted Living Facility | 2122 N Myrtle Ave, Jacksonville, FL 32209-5633 | 2019-05-16 |
| 1194113670 | Bishop Home Care Inc | Assisted Living Facility | 16308 Magnolia Grove Way, Jacksonville, FL 32218-0116 | 2015-01-06 |
| 1861896284 | Stephanie's Love & Care (alf) | Assisted Living Facility | 3056 W 1st St, Jacksonville, FL 32254-2539 | 2014-10-14 |
| 1245643915 | Golden Retreat Shelter Care Center, Inc. | Assisted Living Facility | 4410 Moncrief Rd W, Jacksonville, FL 32209-1228 | 2014-06-10 |
| 1215353370 | Arlington Adult Residential Facility, Inc. | Assisted Living Facility | 6300 Arlington Expy, Jacksonville, FL 32211-7144 | 2014-03-13 |
| 1679997704 | Watts Guardian Care, Inc. | Assisted Living Facility | 7217 Eudine Dr N, Jacksonville, FL 32210-2628 | 2014-02-10 |
| 1164868923 | Circle of Hope Inc | Assisted Living Facility | 1550 W 9th St, Jacksonville, FL 32209-5410 | 2013-05-20 |
| 1851736540 | Autumn Village, Inc. | Assisted Living Facility | 1103 Barrs Street, Jacksonville, FL 32204 | 2013-05-08 |
| 1265780274 | Wiley Retirement Home | Assisted Living Facility | 7024 Wiley Rd, Jacksonville, FL 32210-2736 | 2012-08-22 |
| 1447567540 | Second Beginnings Alf | Assisted Living Facility | 7306 Maple Tree Dr, Jacksonville, FL 32277-2806 | 2010-09-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32211 |
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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.