Individual provider Active NPI

Jeanette Maria Gabay

  • Assisted Living Facility
  • Titusville, FL
National Provider Identifier
1669930921
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
10800 Issued in FL
Practice address
1832 Country Club Dr
Titusville, FL 32780-5346
Phone
(407) 709-8606
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 10800 FL Primary

Addresses

Primary practice location

1832 Country Club Dr
Titusville, FL 32780-5346

Mailing address

1969 S Alafaya TRL # 206
Orlando, FL 32828-8732
Phone (407) 709-8606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10800FLMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1669930921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 S ALAFAYA TRL # 206",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288732",
            "telephone_number": "407-709-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 COUNTRY CLUB DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805346",
            "telephone_number": "407-709-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABAY",
        "first_name": "JEANETTE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.