Banyan Realty BR, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12548 Issued in FL

Legal business name

BANYAN REALTY BR, LLC

Practice address

2950 NW 5TH Ave
Boca Raton, FL 33431-8226

Phone

(561) 571-0300

Fax

(561) 347-8858

NPI assigned

Dec 31, 2014

Organization subpart

No

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

Authorized official

Name

Kevin P Wrenne

Title

Exec. Dir.

Phone

(561) 571-0300

Specialties & licenses 1

Addresses

Other names 1

• Banyan Place Doing business as

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1295123172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 NW 5TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334318226",
            "telephone_number": "561-571-0300",
            "fax_number": "561-347-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 NW 5TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334318226",
            "telephone_number": "561-571-0300",
            "fax_number": "561-347-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN REALTY BR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "WRENNE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXEC. DIR.",
        "authorized_official_telephone_number": "561-571-0300"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banyan Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alan R Bank, M.D.
• Belinda Banuchi
• Robert Banuchi, DC
• Elizabeth Banville
• Banyan Boca FL Management LLC
• Baptist Health Surgery Center, LLC
• Baptist Surgery and Endoscopy Centers LLC
• Jaime L Baquero, MD
• Aliza Bar-Chaim, LMHC
• Dena R Barash, LCSW LMFT

• Assisted Living Facility in Boca Raton, FL
• Providers in Boca Raton, 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 Dec 31, 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.