NPIMap

Organization Active NPI

Marydale Inc

  • Assisted Living Facility
  • Clearwater, FL
National Provider Identifier
1356778674
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL5035 Issued in FL
Legal business name
MARYDALE INC
Practice address
1743 Sharondale Dr
Clearwater, FL 33755-2339
Phone
(727) 461-5907
NPI assigned
Oct 1, 2013
Last updated
Oct 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Authorized official

Name
Mr. Bing G Santiano
Title
President
Phone
(727) 642-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL5035 FL Primary

Addresses

Primary practice location

1743 Sharondale Dr
Clearwater, FL 33755-2339

Mailing address

1743 Sharondale Dr
Clearwater, FL 33755-2339
Phone (727) 461-5907

National Provider Directory

National Provider Directory
Tax ID family
Marydale Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1356778674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 SHARONDALE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552339",
            "telephone_number": "727-461-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 SHARONDALE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552339",
            "telephone_number": "727-461-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYDALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "SANTIANO",
        "authorized_official_first_name": "BING",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-642-6900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.