Camelot Realty LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5429 Issued in FL

Legal business name

CAMELOT REALTY LLC

Practice address

1831 SE Lake Weir Ave
Ocala, FL 34471-5412

Phone

(352) 629-6077

Fax

(352) 629-3792

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Terry L Russell

Title

Manager

Phone

(727) 489-0857

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Camelot Chateau Doing business as

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1326215625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OAK MANOR LN",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337741212",
            "telephone_number": "727-489-0857",
            "fax_number": "727-489-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 SE LAKE WEIR AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715412",
            "telephone_number": "352-629-6077",
            "fax_number": "352-629-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT REALTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-489-0857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14396601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Chateau",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Camelot Chateau Assisted Living LLC
• Camelot Chateau Management Company LLC
• Camelot Community Care
• Camelot Community Care, Inc
• Camelot Community Care, Inc
• Cameo Pharmacy LLC
• Stephanie Lynne Cameron
• Anthony James Campbell, PHARM D
• Jennifer Campbell
• Jennifer Campbell, PHD

• Assisted Living Facility in Ocala, FL
• Providers in Ocala, 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 May 15, 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.