The Palms of Florida Afch, LLC

Primary specialty

HomemakerTaxonomy code 376J00000X

License

6906335 Issued in FL

Legal business name

THE PALMS OF FLORIDA AFCH, LLC

Practice address

2460 S Courtenay Pkwy
Merritt Island, FL 32952-4117

Phone

(321) 215-1641

NPI assigned

Mar 29, 2013

Organization subpart

Yes

Parent organization

THE PALMS OF FLORIDA AFCH, LLCAs reported in NPPES

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

Authorized official

Name

Miss Jeannette L Prophete, LPN

Title

Administrator

Phone

(321) 735-0814

Specialties & licenses 1

Addresses

Part of

The Palms of Florida Afch LLC

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364515200000",
    "number": "1629311501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 S COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524117",
            "telephone_number": "321-735-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 S COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524117",
            "telephone_number": "321-215-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PALMS OF FLORIDA AFCH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PALMS OF FLORIDA AFCH, LLC",
        "enumeration_date": "2013-03-29",
        "last_updated": "2013-03-29",
        "status": "A",
        "authorized_official_last_name": "PROPHETE",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-735-0814",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": "FL",
            "license": "6906335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Homemaker in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Homemaker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.