Brandywyne Assisted Living Facility, LLC.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRANDYWYNE ASSISTED LIVING FACILITY, LLC.

Practice address

1801 Lake Mariam Dr
Winter Haven, FL 33884-0927

Phone

(813) 293-9981

NPI assigned

Jan 8, 2018

Organization subpart

No

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

Authorized official

Name

Khalid Sakr

Title

Manager

Phone

(727) 439-5363

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1477060754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 E 131ST AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124690",
            "telephone_number": "813-293-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LAKE MARIAM DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338840927",
            "telephone_number": "813-293-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWYNE ASSISTED LIVING FACILITY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "SAKR",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-439-5363"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph J Bradfield, M.D.
• Wilma Mae Bradshaw-Mims, L.C.S.W.
• Kayshia Brady, ATC
• Krischell Scarleth Brand, MA73471
• Brandywine Convalescent Center Inc (Brandywyne Health Care Center)
• Lisa Ann Branscum, OTR
• Sonya Braudway, O.D.
• Katherine Breeden
• Haylee Brescia, SLPA
• Adam Breunig, MD

• Assisted Living Facility in Winter Haven, FL
• Providers in Winter Haven, 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 Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.