Magnolia Manor of Palm Coast, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9708 Issued in FL

Legal business name

MAGNOLIA MANOR OF PALM COAST, INC.

Practice address

35 Burning Sands LN
Palm Coast, FL 32137-8808

Phone

(386) 447-8562

Fax

(386) 447-8563

NPI assigned

Oct 2, 2013

Last updated

Oct 2, 2013By 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

Dr. Juanita Marzan Castaneda, M.D.NPI 1497744148

Title

Part Owner

Phone

(216) 214-6176

Specialties & licenses 1

Addresses

Locations

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.

• Juanita M Castaneda, M.D.

  • Internal Medicine Physician
  • Pepper Pike, OH
  • NPI 1497744148
  Authorized official Same address or phone

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1447687637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BURNING SANDS LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378808",
            "telephone_number": "386-447-8562",
            "fax_number": "386-447-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BURNING SANDS LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378808",
            "telephone_number": "386-447-8562",
            "fax_number": "386-447-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR OF PALM COAST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "MARZAN",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "216-214-6176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• L'Kescha Mack
• Dawn Hostetler Macmillan, AU.D., CCC-A
• Tara Lee Madison
• Jessie Bech Magee, DMD
• Shawn Magee
• Parminder Singh Mahal, M.D.
• Sky Leigh Maher
• Mohammed Yasin Ibrahim Mahgoub, MD
• Aimee Mahoney, M.S, CCC-SLP
• Jeremiah J Mahoney, D.M.D.

• Assisted Living Facility in Palm Coast, FL
• Providers in Palm Coast, 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 Oct 2, 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.