Orchid Island Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL4941 Issued in FL

Legal business name

ORCHID ISLAND MANOR, LLC

Practice address

1914 21St St
Vero Beach, FL 32960-3489

Phone

(772) 567-6769

Fax

(772) 567-5289

NPI assigned

Sep 26, 2012

Organization subpart

No

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

Authorized official

Name

Diane E. Lubrano

Title

Owner

Phone

(772) 567-6769

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1316298615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603489",
            "telephone_number": "772-567-6769",
            "fax_number": "772-567-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603489",
            "telephone_number": "772-567-6769",
            "fax_number": "772-567-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHID ISLAND MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "LUBRANO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-567-6769"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL4941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677642600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Vero Beach, FL
• Providers in Vero Beach, 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 Sep 26, 2012; 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.