Avalon Manor Assisted Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12029 Issued in FL

Legal business name

AVALON MANOR ASSISTED LIVING FACILITY LLC

Practice address

2580 First St
Fort Myers, FL 33901-2410

Phone

(239) 479-5282

NPI assigned

Mar 11, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Deosaran

Title

Owner

Phone

(239) 479-5282

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1609237163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 FIRST STREET",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "239-479-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 FIRST ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012410",
            "telephone_number": "239-479-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON MANOR ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "DEOSARAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-479-5282",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Aunkst, CRNA
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• Autism Services of FL
• Stephanie Autore, APRN
• Avalon Assisted Living
• Danny Juan Avalos, M.D.
• Avid Intellectual Inc.
• Regla Avila Nunez
• Amanda Jane Avila, MD
• Carlos Aviles-Berrios

• Assisted Living Facility in Fort Myers, FL
• Providers in Fort Myers, 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 11, 2016; 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.