Coastal Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11441 Issued in FL

Legal business name

COASTAL LIVING LLC

Doing business as

Banana River Villas

Practice address

1275 N Banana River Dr
Merritt Island, FL 32952-5788

Phone

(321) 704-6190

Fax

(407) 386-6267

NPI assigned

Mar 27, 2013

Last updated

Mar 27, 2013By 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

Mrs. Andrea E Fines, RN

Title

Owner

Phone

(407) 451-5894

Specialties & licenses 1

Addresses

Other names 1

• Banana River Villas Doing business as

Locations

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1568705606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 33RD ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328398852",
            "telephone_number": "407-451-5894",
            "fax_number": "407-386-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N BANANA RIVER DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525788",
            "telephone_number": "321-704-6190",
            "fax_number": "407-386-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "FINES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-451-5894",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banana River Villas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elsa Marie Clark, MPT
• Colton C Clary, PT, DPT
• Classic Homecare, LLC
• Alyssa Coan, MSW
• Coast Dental P.a. (Coast Dental-Merritt Island)
• Coastal Living LLC Dba Banana River Villas Assisted Living Facility
• Coastal Pediatric Speech Therapy LLC
• Leon A Cohen, MD
• Michael Thomas Coker, LMT
• Anna Michelle Collings, A.P., D.O.M.

• Assisted Living Facility in Merritt Island, FL
• Providers in Merritt Island, 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 Mar 27, 2013; 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.