NPIMap

Organization Active NPI

Emeritus Corporation

Doing business as Brookdale Fort Myers Cypress Lake

  • Assisted Living Facility
  • Fort Myers, FL
National Provider Identifier
1174851570
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL9430 Issued in FL
Legal business name
EMERITUS CORPORATION
Doing business as
Brookdale Fort Myers Cypress Lake
Practice address
7460 Lake Breeze Dr
Fort Myers, FL 33907-8090
Phone
(239) 454-4100
NPI assigned
Nov 23, 2009
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Anna F.C. Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9430 FL Primary

Addresses

Primary practice location

7460 Lake Breeze Dr
Fort Myers, FL 33907-8090

Mailing address

7460 Lake Breeze Dr
Fort Myers, FL 33907-8090
Phone (239) 454-4100

Other identifiers 1

IdentifierTypeStateIssuer
0092973-00MedicaidFL

Other names 1

  • Brookdale Fort Myers Cypress Lake Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0956155Brookdale Fort Myers Cypress Lake7460 Lake Breeze Dr, Fort Myers, FL 33907Certificate of waiverJan 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brea Emeritus LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1174851570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7460 LAKE BREEZE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078090",
            "telephone_number": "239-454-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7460 LAKE BREEZE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078090",
            "telephone_number": "239-454-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092973-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Fort Myers Cypress Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale Fort Myers Cypress Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.