BVM Lakeshore LLC,

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7531 Issued in FL

Legal business name

BVM LAKESHORE LLC,

Doing business as

Renaissance Village

Practice address

16001 Lakeshore Villa Drive
Tampa, FL 33613

Phone

(813) 968-5093

Fax

(813) 968-5093

NPI assigned

Nov 14, 2013

Last updated

Nov 14, 2013By 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. Robert L Rynard Sr.

Title

Chairman / President

Phone

(317) 627-0504

Specialties & licenses 2

Addresses

Other names 1

• Renaissance Village Doing business as

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1710317532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 501188",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46250",
            "telephone_number": "317-806-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 LAKESHORE VILLA DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613",
            "telephone_number": "813-968-5093",
            "fax_number": "813-968-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BVM LAKESHORE LLC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "RYNARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN / PRESIDENT",
        "authorized_official_telephone_number": "317-627-0504",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7531",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "1282096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Tampa, FL
• Providers in Tampa, 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 Nov 14, 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.