Grand Fortune Group

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7215 Issued in FL

Legal business name

GRAND FORTUNE GROUP

Practice address

2411 Fortune Rd
Kissimmee, FL 34744-3964

Phone

(407) 348-6100

Fax

(407) 348-0031

NPI assigned

Feb 17, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan Bartolo

Title

Cfo

Phone

(407) 348-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amber Lake Assisted Living Doing business as

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1295032829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443964",
            "telephone_number": "407-348-6100",
            "fax_number": "407-348-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443964",
            "telephone_number": "407-348-6100",
            "fax_number": "407-348-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND FORTUNE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "BARTOLO",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "407-348-6100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140952200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amber Lake Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lilian Gracia, MD
• Neil Gracia, MA 61442
• Megan Elizabeth Graf, OTR/L
• Ebony Sharmane Graham
• Maria Granado
• Melysandra Corae Granja
• Gilma A Granobles
• Chelsea Lynn Grant, MD
• Iman K Grant
• Charles Grapski Jr.

• Assisted Living Facility in Kissimmee, FL
• Providers in Kissimmee, 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 Feb 17, 2011; 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.