Deltona Alf Management

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL13087 Issued in FL

Legal business name

DELTONA ALF MANAGEMENT

Practice address

2306 N Normandy Blvd
Deltona, FL 32725

Phone

(386) 259-3860

Fax

(386) 259-3872

NPI assigned

Nov 16, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Derick Wayne Deeter

Title

Manager

Phone

(407) 202-0046

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gold Choice Deltona Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513728000000",
    "number": "1023550498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 N. NORMANDY BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "32725",
            "telephone_number": "386-259-3860",
            "fax_number": "386-259-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 N NORMANDY BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "32725",
            "telephone_number": "386-259-3860",
            "fax_number": "386-259-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTONA ALF MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2017-12-20",
        "status": "A",
        "authorized_official_last_name": "DEETER",
        "authorized_official_first_name": "DERICK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-202-0046",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL13087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022682200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Choice Deltona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie De Jesus
• Raudaliza De Los Santos
• Victoria M Dejesus, L.P.N.
• Morgahn Delacruz
• Lenny Delgado, RBT-25-450089
• Deltona Chiropractic & Advanced Pain Management Center, LLC
• Deltona Chiropractic & Advanced Pain Manangement Center LLC
• Deltona Health Care Associates LLC
• Deltona Medical Arts Pharmacy Inc
• Deltona Operating LLC

• Assisted Living Facility in Deltona, FL
• Providers in Deltona, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.