Shallom Manor Retirement

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5167 Issued in FL

Legal business name

SHALLOM MANOR RETIREMENT

Practice address

2771 NW 58TH Ter
Lauderhill, FL 33313-2384

Phone

(954) 485-0901

Fax

(954) 717-2867

NPI assigned

May 7, 2009

Organization subpart

No

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

Authorized official

Name

Emmins H Henry

Title

President

Phone

(954) 485-0901

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon Mondesir, O.D.

  • Optometrist
  • Orlando, FL
  • NPI 1992967038
  NPD (past)
• Elena Neveux, O.D.

  • Optometrist
  • St Petersburg, FL
  • NPI 1881783215
  NPD (past)

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1649404476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 NW 58TH TER",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333132384",
            "telephone_number": "954-485-0901",
            "fax_number": "954-717-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 NW 58TH TER",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333132384",
            "telephone_number": "954-485-0901",
            "fax_number": "954-717-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALLOM MANOR RETIREMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "EMMINS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-485-0901"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio Jacas DMD LLC
• Keyla Marie Serrano, MS
• Sesame Flyers of South Florida Inc.
• Shades of Visions for Better Living LLC.
• Himadri Shah, DO
• Shared Inc About Eyes
• Mohammad Tayyab Sheikh
• Sheldon H. Kreda, O.D., P.a.
• Myron Orlando Sheriff Sr., LMT/CKTP PLLC
• Ayanna Shields, BSN, RN

• Assisted Living Facility in Lauderhill, FL
• Providers in Lauderhill, 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, 2009; 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.