FLORIDA DEPARTMENT OF VETERANS AFFAIRS (NPI# 1962494518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962494518 |
Entity Type | Organization |
Organization Name | FLORIDA DEPARTMENT OF VETERANS AFFAIRS |
Other Organization Name | ROBERT H JENKINS JR VETERANS DOMICILIARY HOME OF FLORIDA |
Practice Address |
751 Se Sycamore Ter Lake City FL 32025-6216 |
Practice Telephone | 3867580600 |
Practice Fax Number | 3867580549 |
Mailing Telephone | 3867580600 |
Mailing Fax Number | 3867580549 |
Enumeration Date | 2005-08-19 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. WILLIAM C PUCKETT (PROGRAM DIRECTOR) |
Authorized Official Telephone | 7275183202 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | AL7975 | FL | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Robert H Jenkins Jr Veterans Domiciliary Home of Florida | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912215583 | Florida Department of Veterans Affairs | Skilled Nursing Facility | 4650 State Road 16, Saint Augustine, FL 32092-0600 | 2010-09-17 |
1174515654 | Florida Department of Veterans Affairs | Skilled Nursing Facility | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2005-08-19 |
1629060272 | Florida Department of Veterans Affairs | Alzheimer Center (Dementia Center) | 21281 Grayton Ter, Port Charlotte, FL 33954-3109 | 2005-08-19 |
1316939804 | Florida Department of Veterans Affairs | Skilled Nursing Facility | 6919 Parkway Blvd, Land O Lakes, FL 34639-2909 | 2005-08-19 |
1518959667 | Florida Department of Veterans Affairs | Alzheimer Center (Dementia Center) | 4419 Tram Rd, Panama City, FL 32404-2559 | 2005-08-16 |
1417949579 | Florida Department of Veterans Affairs | Alzheimer Center (Dementia Center) | 8401 W Cypress Dr, Pembroke Pines, FL 33025-4540 | 2005-08-16 |
Street Address |
751 SE SYCAMORE TER |
City | LAKE CITY |
State | FL |
Zip Code | 32025-6216 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841713674 | Nai Chen | Pharmacist | 751 Se Sycamore Ter, Lake City, FL 32025-6216 | 2017-07-24 |
1730630880 | Rene Walberto Zambrana | Nurse Practitioner | 751 Se Sycamore Ter, Lake City, FL 32025-6216 | 2016-10-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
Find all providers in zip 32025 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
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. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235745753 | Shenay Fulton | Assisted Living Facility | 536 Nw Shelby Ter, Lake City, FL 32055-3280 | 2020-09-21 |
1265071153 | Serenity Hill Assisted Living Facility | Assisted Living Facility | 3534 230th Ter, Lake City, FL 32024-2714 | 2019-12-25 |
1902447527 | Harper Lake Operations, LLC | Assisted Living Facility | 213 Nw Gleason Dr, Lake City, FL 32055-5846 | 2019-10-04 |
1598247009 | Mardell Jackson | Assisted Living Facility | 197 Nw Gwen Lake Ave, Lake City, FL 32055-3711 | 2018-08-30 |
1114420502 | Ets Willowbrook At Marion | Assisted Living Facility | 1580 S Marion Ave, Lake City, FL 32025-6913 | 2018-03-13 |
1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
1467878454 | Hendrix, Smith, & Kirby LLC D/b/a Eastside Care Alf | Assisted Living Facility | 152 Se Defender Dr, Lake City, FL 32025-4990 | 2014-03-14 |
1881010072 | Summers Assisted Living Facility | Assisted Living Facility | 1225 Sw Grandview St, Lake City, FL 32025-0740 | 2014-03-12 |
1366866097 | Clara Ferguson I | Assisted Living Facility | 184 Se Beech St, Lake City, FL 32025-4982 | 2014-02-17 |
1417383241 | The Plantation On Summers LLC | Assisted Living Facility | 147 Sw Summers Ln, Lake City, FL 32025-0762 | 2013-09-25 |
Find all providers in LAKE CITY |
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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.