Guardian Home II Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL55 Issued in FL

Legal business name

GUARDIAN HOME II ALF LLC

Practice address

902 Canal St.
New Smyrna Beach, FL 32168

Phone

(386) 409-9455

Fax

(386) 409-9456

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Gladys Fernando, RN

Title

Administrator

Phone

(386) 409-9456

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1174707640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 EAST AIRPORT BLVD.",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735494",
            "telephone_number": "407-323-2545",
            "fax_number": "407-323-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 CANAL ST.",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-409-9455",
            "fax_number": "386-409-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN HOME II ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-409-9456",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142656700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory P. Samano D.O., P.a.
• Emily Gregory
• Stephen Patrick Griffith, MD
• Myriam F Grondal
• Amy M Grossi, CLC
• Stephania Guerrero
• Jennifer Guiliano
• Courtney Leah Gunn, PHARMD
• Mallory Gunther
• H2 Rehabilitation Services of Florida LLC (H2 Health)

• Assisted Living Facility in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.