Pelican Haven,LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

089390 Issued in FL

Legal business name

PELICAN HAVEN,LLC

Practice address

4310 14TH St SW
Lehigh Acres, FL 33976-2731

Phone

(239) 674-7051

NPI assigned

Sep 13, 2010

Organization subpart

No

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

Authorized official

Name

Yvonne Julmeus

Title

Director/Owner

Phone

(239) 872-0718

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1093022980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 14TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339762731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 14TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339762731",
            "telephone_number": "239-674-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN HAVEN,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "JULMEUS",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "239-872-0718"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "FL",
            "license": "001926400",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "089390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001925800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001302600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001926400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nickalea Pedley
• Elizabeth Pedregal, M.ED
• Daylin De la Caridad Pedrero Gonzalez
• Pedro Ylisastigui. M.D.P.a.
• Liriam Maria Pelaez Menendez
• Pelican Pediatric Dentistry LLC
• Edel Raul Pena de la Cruz
• Thelma Lissette Pena Lozano
• Keyla De la Caridad Pena Perez I, RBT
• Lianis Pena Zamora

• Community Based Hospice Care Agency in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Community Based Hospice Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.