Ltcsp Pasadena, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF14320962 Issued in FL

Legal business name

LTCSP PASADENA, LLC

Doing business as

Pasadena Manor

Practice address

1430 Pasadena Ave S
South Pasadena, FL 33707-3716

Phone

(727) 347-1257

Fax

(727) 381-5407

NPI assigned

Jun 13, 2005

Last updated

Oct 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Howard Jaffe

Title

President

Phone

(215) 346-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pasadena Manor Doing business as

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1124022603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 PALM BEACH LAKES BLVD",
            "address_2": "SUITE 900",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-801-7600",
            "fax_number": "414-268-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 PASADENA AVE S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337073716",
            "telephone_number": "727-347-1257",
            "fax_number": "727-381-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTCSP PASADENA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-346-6454"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF14320962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028189100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasadena Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darren W. Leverenz, M.D.
• Lori Marie Levin, LPN
• Alan Mark Levine, M.D.
• Lori Prince LCSW PA
• LP St. Petersburg Pasadena, LLC (Gulfport Rehabilitation Center)
• Nicolas Lyde, PA
• Lindsay Macgregor
• Heather M Magee, BC-HIS
• Michael Maiello
• Sara Justine Maison, LMFT

• Skilled Nursing Facility in South Pasadena, FL
• Providers in South Pasadena, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.