MJ Childrens Pavillion, Ins

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12589 Issued in FL

Legal business name

MJ CHILDRENS PAVILLION, INS

Practice address

728 S Endeavour Dr
Winter Springs, FL 32708-5167

Phone

(407) 699-4255

NPI assigned

Jan 15, 2015

Organization subpart

Yes

Parent organization

MJ CHILDRENS PAVILLION, INCAs reported in NPPES

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

Authorized official

Name

Ms. Joan Tyrell

Title

Administrator

Phone

(407) 699-4255

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• M J Pavillion at Drayton Doing business as

Tax ID family

MJ Childrens Pavillion Ins2 organizations share this tax ID, including this one

Part of

MJ Childrens Pavillion Ins

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• MJ Children Pavillion, Inc

  • Foster Care Agency
  • Winter Springs, FL
  • NPI 1457601148
  NPD tax ID

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1316336266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 S ENDEAVOUR DR",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 S ENDEAVOUR DR",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085167",
            "telephone_number": "407-699-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ CHILDRENS PAVILLION, INS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MJ CHILDRENS PAVILLION, INC",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "TYRELL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-699-4255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457601148",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M J Pavillion at Drayton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mid Florida Hospital Specialists PA
• Rhonda Lynn Miller, RDH
• Timothy Millward, DMD
• William James Mitchell III, DMD
• MJ Children Pavillion, Inc
• Mojica Chiropractic Care, LLC
• Melissa Molina
• Timothy Reed Monaco
• Claudia Gabriela Montero, RBT
• Jenine L Moore

• Assisted Living Facility in Winter Springs, FL
• Providers in Winter Springs, 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 Jan 15, 2015; 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.