Bimini Manor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10566 Issued in FL

Legal business name

BIMINI MANOR

Practice address

3791 67TH Ave N
Pinellas Park, FL 33781-6174

Phone

(727) 458-6621

NPI assigned

Apr 18, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Laura Keller

Title

Owner

Phone

(727) 458-6621

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1194015636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3791 67TH AVE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337816174",
            "telephone_number": "727-458-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 67TH AVE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337816174",
            "telephone_number": "727-458-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIMINI MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-458-6621",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethe Health Inc.
• Beyond 2020 Vision Specialists Pinellas Park LLC
• Barbara Jean Biava
• Brienna Bilbrey
• Jennifer Jo Bills, BSW, MA
• Carly Rae Bines
• Bio-Medical Applications of Florida, Inc.
• Carolyn Alexis Bird, MPAS
• Nicole Michelle Bishko, D. O.
• Paul Bivens, DDS

• Assisted Living Facility in Pinellas Park, FL
• Providers in Pinellas Park, 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 17, 2014; 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.