Agnes Cottage LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AGNES COTTAGE LLC

Doing business as

Coquina Cove ALF

Practice address

3739 Sunrise Oaks Dr
Port Orange, FL 32129-8651

Phone

(386) 265-4732

Fax

(407) 902-0121

NPI assigned

Apr 15, 2021

Last updated

Sep 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abiola ByronNPI 1487269411

Title

Adminstrator

Phone

(240) 550-2211

Specialties & licenses 1

Addresses

Other names 1

• Coquina Cove ALF Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abiola Byron

  • Registered Nurse
  • Port Orange, FL
  • NPI 1487269411
  NPD Authorized official

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1407437106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10957 LEDGEMENT LN",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866423",
            "telephone_number": "240-550-2211",
            "fax_number": "407-902-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 SUNRISE OAKS DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321298651",
            "telephone_number": "386-265-4732",
            "fax_number": "407-902-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES COTTAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "BYRON",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "240-550-2211"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coquina Cove ALF",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coquina Cove ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adventhealth Imaging Center Port Orange
• Adventist Health System/Sunbelt, Inc (AdventHealth Primary Care Plus -Port Orange)
• Adventist Health System/Sunbelt, Inc. (AdventHealth Centra Care - Port Orange)
• Aegis Homemaking, Companion & Chore Service of Volusia County
• Philip A Afghani, DC
• Louis Michael Agnone, MD
• Marlenne Dalila Aguilar, PTA
• Sierra Aiken
• Brittany Akin
• Esitime Akpanuko

• Assisted Living Facility in Port Orange, FL
• Providers in Port Orange, 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 20, 2021; 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.