Ft Myers Alf BSLC LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5096 Issued in FL

Legal business name

FT MYERS ALF BSLC LLC

Doing business as

LAMPLIGHT INN

Practice address

1896 Park Meadows Dr
Fort Myers, FL 33907-3738

Phone

(239) 939-5421

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

Liza Rojas

Title

Manager

Phone

(941) 809-6147

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LAMPLIGHT INN Doing business as

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1184073363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1896 PARK MEADOWS DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073738",
            "telephone_number": "239-939-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 PARK MEADOWS DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073738",
            "telephone_number": "239-939-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT MYERS ALF BSLC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-809-6147"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "AL5096",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAMPLIGHT INN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Fry, ARNP
• Malorie Nicole Fry, MS, RD
• Olivia Fry, RMHCI
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• Ft. Myers Chiropractic Center, Inc.
• Ft. Myers Dental Services, PA

• Assisted Living Facility in Fort Myers, FL
• Providers in Fort Myers, 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 Jun 8, 2016; 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.