Bridgeport Senior Living - Port Isle
Organization Active NPI Assisted Living Facility · Windermere, FL
NPI 1124460969 · NPPES record last updated Jul 22, 2013
Key facts
- NPI
- 1124460969
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- AL12372 (FL)
- Legal business name
- BRIDGEPORT SENIOR LIVING - PORT ISLE
- Practice address
- 13506 Summerport Village Pkwy
129
Windermere, FL 34786-7366 - Phone
- (407) 203-0868
- NPI assigned
- Jul 22, 2013
- Organization subpart
- No
Authorized official
- Name
- Kevin Galbasini
- Title
- Managing Partner
- Phone
- (407) 760-3649
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL12372 | FL | Yes |
Addresses
Primary practice location
13506 Summerport Village Pkwy
129
Windermere, FL 34786-7366
Mailing address
13506 Summerport Village Pkwy
129
Windermere, FL 34786-7366
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083957039 | Medicaid | FL |
Other providers in Windermere, FL
- Jennifer Anfinson Bittner
- Caitlin Rae Boersma
- Rachel Bond
- John Boyd Jr.
- Brenda J. Singrossi
- Bridgeport Senior Living - Port Isle LLC
- Michelle Brody
- Kristin Brown-James
- Sherecka Brown
- Kimberly Ann Bruno-de la Mata
All providers in Windermere, FL · Assisted Living Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.