Tucawilla Villa, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906719 Issued in FL

Legal business name

TUCAWILLA VILLA, LLC

Practice address

995 Tuscawilla Road
Winter Springs, FL 32708

Phone

(407) 637-0273

NPI assigned

Mar 10, 2016

Last updated

Mar 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie M Harry, RN/RDNPI 1508359118

Title

Owner/Administrator

Phone

(407) 637-0273

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jamie McCaslin Harry, RD, RN

  • Registered Dietitian
  • Tulsa, OK
  • NPI 1508359118
  Authorized official Same address or phone

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1225499817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 TUSCAWILLA ROAD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "32708",
            "telephone_number": "407-637-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 TUSCAWILLA ROAD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "32708",
            "telephone_number": "407-637-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCAWILLA VILLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "HARRY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "407-637-0273",
        "authorized_official_credential": "RN/RD"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS TAX RECEIPT- FLORIDA DIVISION OF CORPORATION",
            "identifier": "213000110783",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE FOR ADULT FAMILY CARE HOME-",
            "identifier": "6906719",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uyen Tran
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• Sinisa Marko Trbovic, MD, PHD
• Tree of Life Family Medicine LLC
• John W Treharne, MD
• Lisa Michelle Turner, LCSW
• Tuskawilla Family Medicine, Inc..
• Megan Nicole Twiddy
• Joan Tyrell Chambers
• Schaneal Marie Unietis, FNP-C

• Adult Care Home Facility in Winter Springs, FL
• Providers in Winter Springs, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.