Elridge Daigle Jr.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906187 Issued in FL

Practice address

10507 Sedgebrook Dr
Riverview, FL 33569-8701

Phone

(813) 672-3880

NPI assigned

Feb 26, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1689914749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10507 SEDGEBROOK DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698701",
            "telephone_number": "813-672-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10507 SEDGEBROOK DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698701",
            "telephone_number": "813-672-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "ELRIDGE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143044100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Cupo, RN
• Samantha Cuva
• Yadiris Czerniak, CRNP
• Da Right Way Transportation
• Debra J Dahlberg, OD
• Michael James Daly
• Casey Damato, BA
• Hannah R Dame, M.A. CCC-SLP
• Cameron L. Dang, CRNA
• Paul Tri Thanh Dang, DNP, ARNP, PMHNP

• Adult Care Home Facility in Riverview, FL
• Providers in Riverview, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.