Michele M Gavin, OWNER

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

6969062 Issued in FL

Practice address

3450 Kaiser Ave
Saint Cloud, FL 34772-7311

Phone

(407) 301-8804

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1629692736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 OLD CANOE CREEK RD UNIT 702121",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347707086",
            "telephone_number": "407-301-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 KAISER AVE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347727311",
            "telephone_number": "407-301-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MICHELE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "OWNER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "FL",
            "license": "6969062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Home Administrator in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Nursing Home Administrator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.