Angel Guardian Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10561 Issued in FL

Legal business name

ANGEL GUARDIAN ASSISTED LIVING

Practice address

280 Bahama Dr
Merritt Island, FL 32952-3605

Phone

(321) 848-0255

NPI assigned

Apr 10, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Roseann J SimoneNPI 1184967184

Title

Administrator

Phone

(321) 223-8371

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 1

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

• Roseann Judith Simone

  • Assisted Living Facility
  • Cocoa Beach, FL
  • NPI 1184967184
  NPD (past) Authorized official

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1649699265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BAHAMA DR.",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-848-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BAHAMA DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523605",
            "telephone_number": "321-848-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL GUARDIAN ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "SIMONE",
        "authorized_official_first_name": "ROSEANN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-223-8371",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL SOCIAL SECURITY",
            "identifier": "$$$$$$$$$",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE #",
            "identifier": "AL10561",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI #",
            "identifier": "1184967184",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008458000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara L Anderson, RN
• Kimberly Anderson, LMT
• Stephanie Spain Anderson, PHD, LMHC
• Theresa J. Anderson, AP
• Louise R Andrews
• Anthony J. Sidor, D.D.S., P.a.
• Anytime Dental Centers, LLC
• Aquatic Health and Rehabilitation Services Inc
• Sharon Arboleda
• Armando O Martinez MD PA

• Assisted Living Facility in Merritt Island, FL
• Providers in Merritt Island, 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 21, 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.