NPIMap

Organization Active NPI

Fabulous Resort Assisted Living Facilitator LLC

  • Assisted Living Facility
  • Port Saint Lucie, FL
National Provider Identifier
1083113070
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL13125 Issued in FL
Legal business name
FABULOUS RESORT ASSISTED LIVING FACILITATOR LLC
Practice address
1762 SE Carvalho St
Port Saint Lucie, FL 34983-4554
Phone
(561) 541-2089
NPI assigned
Feb 6, 2018
Last updated
Feb 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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

Authorized official

Name
Fabiola Alexandre
Title
Administrator
Phone
(561) 541-2089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL13125 FL Primary

Addresses

Primary practice location

1762 SE Carvalho St
Port Saint Lucie, FL 34983-4554

Mailing address

1762 SE Carvalho St
Port Saint Lucie, FL 34983-4554
Phone (561) 541-2089

Other names 1

  • Fabiola Alexandre Other name

National Provider Directory

National Provider Directory
Tax ID family
Fabiola Alexandre2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1083113070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 SE CARVALHO ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349834554",
            "telephone_number": "561-541-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 SE CARVALHO ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349834554",
            "telephone_number": "561-541-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABULOUS RESORT ASSISTED LIVING FACILITATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "ALEXANDRE",
        "authorized_official_first_name": "FABIOLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-541-2089"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL13125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fabiola Alexandre",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.