NPIMap

Organization Active NPI

Lubis Enterprise LLC

  • Assisted Living Facility
  • Lady Lake, FL
National Provider Identifier
1447872601
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
LUBIS ENTERPRISE LLC
Practice address
39106 Grays Airport Rd
Lady Lake, FL 32159-4004
Phone
(352) 750-9150
NPI assigned
May 11, 2020
Last updated
May 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Authorized official

Name
Deviano Lubis
Title
Owner
Phone
(352) 787-3034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

39106 Grays Airport Rd
Lady Lake, FL 32159-4004

Mailing address

39106 Grays Airport Rd
Lady Lake, FL 32159-4004

National Provider Directory

National Provider Directory
Tax ID family
Lubis Enterprise LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1447872601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39106 GRAYS AIRPORT RD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39106 GRAYS AIRPORT RD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594004",
            "telephone_number": "352-750-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBIS ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "LUBIS",
        "authorized_official_first_name": "DEVIANO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-787-3034"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.