NPIMap

Organization Active NPI

Extended Care Portfolio Florida Tenant LLC

  • Assisted Living Facility
  • Fort Myers, FL
National Provider Identifier
1679984389
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL9346 Issued in FL
Legal business name
EXTENDED CARE PORTFOLIO FLORIDA TENANT LLC
Practice address
9461 Healthpark Cir
Fort Myers, FL 33908-3614
Phone
(239) 437-5511
Fax
(239) 437-2826
NPI assigned
May 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Authorized official

Name
Depak Israni
Title
General Manager
Phone
(619) 296-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9346 FL Primary

Addresses

Primary practice location

9461 Healthpark Cir
Fort Myers, FL 33908-3614

Mailing address

1775 Hancock St
Suite 200
San Diego, CA 92110-2034
Phone (619) 296-9000

Other names 1

  • Pacifica Senior Living Fort Myers Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1679984389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK ST",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102034",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9461 HEALTHPARK CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083614",
            "telephone_number": "239-437-5511",
            "fax_number": "239-437-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE PORTFOLIO FLORIDA TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.