Organization Active NPI

Loving Care of St Petersburg

  • Assisted Living Facility (Mental Illness)
  • St Petersburg, FL
National Provider Identifier
1285075986
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
11357 Issued in FL
Legal business name
LOVING CARE OF ST PETERSBURG
Practice address
1001 9TH St N
St Petersburg, FL 33701-1514
Phone
(727) 324-9963
NPI assigned
Jul 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Authorized official

Name
Carlos Juan Mazariegos, PHARMD
Title
Administrator
Phone
(727) 823-1625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X 11357 FL Primary

Addresses

Primary practice location

1001 9TH St N
St Petersburg, FL 33701-1514

Mailing address

1001 9TH St N
St Petersburg, FL 33701-1514
Phone (727) 324-9963

Other identifiers 1

IdentifierTypeStateIssuer
000225800MedicaidFL

National Provider Directory

National Provider Directory

Locations

1001 Martin Luther King Dr N
St Petersburg, FL 33701
Phone (727) 324-9963

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1285075986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 9TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011514",
            "telephone_number": "727-324-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 9TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011514",
            "telephone_number": "727-324-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVING CARE OF ST PETERSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "MAZARIEGOS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-823-1625",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "11357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000225800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

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