Florida Shores of Melbourne Assisted Living Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7324 Issued in FL

Legal business name

FLORIDA SHORES OF MELBOURNE ASSISTED LIVING INC.

Doing business as

Florida Shores of Melbourne 1 ALF

Practice address

2155 Keystone Ave
Melbourne, FL 32904-6146

Phone

(646) 541-5552

Fax

(321) 951-0896

NPI assigned

Mar 26, 2013

Last updated

Apr 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Irene Mercado

Title

Secretary

Phone

(646) 541-5552

Specialties & licenses 1

Addresses

Other names 1

• Florida Shores of Melbourne 1 ALF Doing business as

Tax ID family

Florida Shores of Melbourne 1 Alf2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Florida Shores of Melbourne Assisted Living Inc.

  dba Smiles And Loving Care

  • Assisted Living Facility
  • Merritt Island, FL
  • NPI 1144539503
  NPD tax ID

Locations

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1710229976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 KEYSTONE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329046146",
            "telephone_number": "646-541-5552",
            "fax_number": "321-951-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 KEYSTONE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329046146",
            "telephone_number": "646-541-5552",
            "fax_number": "321-951-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SHORES OF MELBOURNE ASSISTED LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "646-541-5552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Shores of Melbourne 1 ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Melbourne, FL
• Providers in Melbourne, 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 Apr 6, 2017; 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.