St. Cloud SLC Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ST. CLOUD SLC OPCO, LLC

Practice address

3791 Old Canoe Creek Rd
Saint Cloud, FL 34769-6630

Phone

(407) 892-8502

NPI assigned

Mar 7, 2023

Organization subpart

No

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

Authorized official

Name

Pilar Carvajal

Title

Ceo

Phone

(305) 428-2480

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1295435311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 W MORSE BLVD STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893781",
            "telephone_number": "305-428-2480",
            "fax_number": "305-428-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 OLD CANOE CREEK RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696630",
            "telephone_number": "407-892-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD SLC OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CARVAJAL",
        "authorized_official_first_name": "PILAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-428-2480"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Cloud Physician Management LLC
• St Cloud Physician Management LLC
• St Cloud Physician Management LLC
• St. Cloud Eye Care
• St. Cloud Eye Center, Inc
• St. Cloud Smiles, Inc.
• St.Cloud Pharmacy & Wellness Center
• St.Cloud Pharmacy&Wellness Center
• St.Cloud Pharmacy&Wellness Center
• Marie Staley

• Assisted Living Facility in Saint Cloud, FL
• Providers in Saint Cloud, 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 Mar 7, 2023; 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.