Lake Smith Shores, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAKE SMITH SHORES, LLC

Practice address

16624 Lake Smith Rd
Umatilla, FL 32784-8838

Phone

(407) 205-5515

Fax

(352) 669-0572

NPI assigned

May 7, 2025

Last updated

May 7, 2025By 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

Regina MarcanoNPI 1790572592

Title

Owner/Administrator

Phone

(407) 205-5515

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Regina Marcano, RN

  • Assisted Living Facility
  • Umatilla, FL
  • NPI 1790572592
  NPD Authorized official

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1619767340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16624 LAKE SMITH RD",
            "city": "UMATILLA",
            "state": "FL",
            "postal_code": "327848838",
            "telephone_number": "407-205-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16624 LAKE SMITH RD",
            "city": "UMATILLA",
            "state": "FL",
            "postal_code": "327848838",
            "telephone_number": "407-205-5515",
            "fax_number": "352-669-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SMITH SHORES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "MARCANO",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "407-205-5515"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dixon Alan Hays, DMD
• Sara Hernandez
• Jennifer S. Holt, DDS
• Hometown Umatilla LLC (Umatilla Drug Store)
• Kennith F Kovarnik, RMHI
• Scott Edward Ledford, LMHC INTERN
• David Scott Levy, PA
• Sandra K Lindsay, APRN NP-C
• Nannette E Liverman
• Louis J Radnothy DO PA

• Assisted Living Facility in Umatilla, FL
• Providers in Umatilla, 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 May 7, 2025; 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.