Bridgeport Senior Living - Port Isle LLC

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

License

12372 Issued in FL

Legal business name

BRIDGEPORT SENIOR LIVING - PORT ISLE LLC

Practice address

13506 Summerport Village Pkwy
#129
Windermere, FL 34786-7366

Phone

(407) 760-3649

NPI assigned

Jun 10, 2014

Last updated

Jun 10, 2014By 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

Kevin Galbasini

Title

Owner

Phone

(407) 760-3649

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1124431762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13506 SUMMERPORT VILLAGE PKWY",
            "address_2": "#129",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347867366",
            "telephone_number": "407-760-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13506 SUMMERPORT VILLAGE PKWY",
            "address_2": "#129",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347867366",
            "telephone_number": "407-760-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT SENIOR LIVING - PORT ISLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "GALBASINI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-760-3649"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "FL",
            "license": "12372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Rae Boersma, PA-C
• Rachel Bond
• John Boyd Jr., PT, DPT
• Brenda J. Singrossi
• Bridgeport Senior Living - Port Isle
• Michelle Brody, LCSW
• Kristin Brown-James
• Sherecka Brown, LMHC
• Kimberly Ann Bruno-de la Mata, M.D.
• Zachary Bunting

• Attendant Care Provider in Windermere, FL
• Providers in Windermere, FL by specialty
• Attendant Care Provider in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.