Estapona Operating, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ESTAPONA OPERATING, LLC

Practice address

7255 Strive Place
Fern Park, FL 32730

Phone

(407) 848-1743

NPI assigned

Oct 9, 2019

Organization subpart

No

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

Authorized official

Name

Carrie Vick

Title

President

Phone

(407) 740-8815

Specialties & licenses 1

Addresses

Other names 1

• Strive at Fern Park Doing business as

Locations

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1164064390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 S HUNT CLUB BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327034948",
            "telephone_number": "407-740-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 STRIVE PLACE",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "32730",
            "telephone_number": "407-848-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTAPONA OPERATING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2022-05-11",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-740-8815"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Strive at Fern Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Strive at Fern Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mearlene Filkins, MSW
• Marie Samantha Florestal, NP

• All providers in Fern Park, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.