Ivy Flo Moore

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906285 Issued in FL

Legal business name

IVY FLO MOORE

Practice address

23145 Gray Ave
Port Charlotte, FL 33980-8587

Phone

(941) 627-5983

NPI assigned

Jan 21, 2014

Organization subpart

No

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

Authorized official

Name

Ivy Flo Moore

Title

Owner

Phone

(941) 627-5983

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1366864795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23145 GRAY AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339808587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23145 GRAY AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339808587",
            "telephone_number": "941-627-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY FLO MOORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "FLO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-627-5983"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ishaani Home Care LLC
• Ishaani LLC
• Yasmeen M Islam, M.D. PA
• Island Adventures Foundation
• Issa F Baroudi MD PA
• Yaidelin Izquierdo Concepcion
• Ashlee Jackimowicz
• Marcy Jackovic
• Jackson Optical LLC
• Jackson Transportation

• Adult Care Home Facility in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.