NPIMap

Organization Active NPI

Deland Geriatric Care, Inc.

  • Assisted Living Facility
  • Deland, FL
National Provider Identifier
1275969628
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL8722 Issued in FL
Legal business name
DELAND GERIATRIC CARE, INC.
Practice address
208 Blue Crystal Drive
Deland, FL 32720
Phone
(386) 679-3375
Fax
(386) 738-9986
NPI assigned
Sep 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Dr. Ramon Lorenzana Gutierrez, DOM
Title
Director, Resident Care Services/Co
Phone
(386) 738-9986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL8722 FL Primary

Addresses

Primary practice location

208 Blue Crystal Drive
Deland, FL 32720

Mailing address

208 Blue Crystal Drive
Deland, FL 32720
Phone (386) 679-3375

Other names 1

  • The Good Shepards-West of deLand Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1275969628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BLUE CRYSTAL DRIVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-679-3375",
            "fax_number": "386-738-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BLUE CRYSTAL DRIVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-679-3375",
            "fax_number": "386-738-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAND GERIATRIC CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "RAMON",
        "authorized_official_middle_name": "LORENZANA",
        "authorized_official_title_or_position": "DIRECTOR, RESIDENT CARE SERVICES/CO",
        "authorized_official_telephone_number": "386-738-9986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOM"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Good Shepards-West of deLand",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.