American Senior Living of Sebring, FL, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5105 Issued in FL

Legal business name

AMERICAN SENIOR LIVING OF SEBRING, FL, LLC

Doing business as

Fairway Pines at Sun N Lakes

Practice address

5959 Sun N Lake Blvd
Sebring, FL 33872-2075

Phone

(863) 385-5454

NPI assigned

Apr 13, 2007

Last updated

Jun 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mederia Doran

Title

Executive Director

Phone

(863) 385-5454

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fairway Pines at Sun N Lakes Doing business as

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1295959815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722075",
            "telephone_number": "863-385-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722075",
            "telephone_number": "863-385-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN SENIOR LIVING OF SEBRING, FL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "DORAN",
        "authorized_official_first_name": "MEDERIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "863-385-5454"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686324800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140900000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairway Pines at Sun N Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juan Carlos Alvarez, M.D.
• Lylibet Alvarez, RBT
• Sahani Seneka de Silva Ambepitiya Waduge, MD
• Marlene Tapales Amellabon, OTR/L
• American Institute of Dermatology PA
• Americare Communities Florida LLC
• Namra Amin, D.M.D
• Amit I Shah M D P a
• Lawrence Mateo Anacay, MD
• Rupesh Andani, MBBS

• Assisted Living Facility in Sebring, FL
• Providers in Sebring, 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 Jun 12, 2008; 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.