Mial LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MIAL LLC

Doing business as

Marina Isle Assisted Living

Practice address

530 N Palmetto Ave
Sanford, FL 32771-1354

Phone

(407) 499-7300

Fax

(407) 732-4665

NPI assigned

Oct 13, 2021

Last updated

Oct 13, 2021By 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

Tom J Campbell

Title

Manager

Phone

(407) 619-0678

Specialties & licenses 1

Addresses

Other names 1

• MARINA ISLE ASSISTED LIVING Doing business as

Electronic endpoints 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: medicaid@marinaisle.com

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1548922958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 TIMBERLACHEN CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463336",
            "telephone_number": "407-222-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N PALMETTO AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711354",
            "telephone_number": "407-499-7300",
            "fax_number": "407-732-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-619-0678"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MEDICAID@MARINAISLE.COM",
            "affiliation": "N",
            "endpointDescription": "MEDICAID ENDPOINT",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "530 N Palmetto Ave",
            "city": "Sanford",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327711354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MARINA ISLE ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rena Mehta, M.D.
• Jannia Mendez, PMHNP
• Madison Mendez
• Jose Luis Mercado Jr., LMT
• Isabel Medora Merrick, BS
• Mid Florida Hematology and Oncology Centers PA
• Mid Florida OB-GYN Specialists
• Mid Florida Physicians Inc
• Mid Florida Rheumatology and Arthritis Center LLC
• Mid-Florida Dermatology Associates

• Assisted Living Facility in Sanford, FL
• Providers in Sanford, 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 13, 2021; 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.