Coral Sea Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CORAL SEA ALF LLC

Practice address

1405 SW 15TH St
Cape Coral, FL 33991-2957

Phone

(239) 265-2005

NPI assigned

Jan 10, 2025

Last updated

Jan 10, 2025By 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

Elizabeth Dominguez Marrero

Title

Owner

Phone

(239) 265-2005

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1730999848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SW 15TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SW 15TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912957",
            "telephone_number": "239-265-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL SEA ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ MARRERO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-265-2005"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julia Ruth Corbin, MS
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• Assisted Living Facility in Cape Coral, FL
• Providers in Cape Coral, 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 Jan 10, 2025; 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.