Individual provider Active NPI

Alejandra Clark

  • Assisted Living Facility (Behavioral Disturbances)
  • Melbourne, FL
National Provider Identifier
1518807403
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
License
13891 Issued in FL
Practice address
863 Pelican LN
Melbourne, FL 32935-6952
Phone
(407) 797-9008
NPI assigned
Mar 30, 2026
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X 13891 FL Primary

Addresses

Primary practice location

863 Pelican LN
Melbourne, FL 32935-6952

Mailing address

863 Pelican LN
Melbourne, FL 32935-6952
Phone (407) 797-9008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13891FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carmita's Care Assisted Living Facility LLC Current Accepting new patients
Carmita's Care II Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1518807403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 PELICAN LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356952",
            "telephone_number": "407-797-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 PELICAN LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356952",
            "telephone_number": "407-797-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALEJANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "FL",
            "license": "13891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.