St. Petersburg Operator LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ST. PETERSBURG OPERATOR LLC

Practice address

6280 Central Ave
St Petersburg, FL 33707-1429

Phone

(727) 954-7015

NPI assigned

Jul 20, 2017

Organization subpart

No

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

Authorized official

Name

Kenneth Assiran

Title

Financial Officer

Phone

(410) 427-2669

Specialties & licenses 1

Addresses

Other names 1

• Brentwood Senior Living at St. Pete Doing business as

Locations

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500508800000",
    "number": "1497278519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 BLAIR HILL LN FL 4",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092042",
            "telephone_number": "410-427-2669",
            "fax_number": "727-289-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071429",
            "telephone_number": "727-954-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETERSBURG OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A",
        "authorized_official_last_name": "ASSIRAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "410-427-2669"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Senior Living at St. Pete",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brentwood Senior Living at St. Pete",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in St Petersburg, FL
• Providers in St Petersburg, 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 Jul 20, 2017; 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.