Andrada Guerzon #1 Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10535 Issued in FL

Legal business name

ANDRADA GUERZON #1 CORP

Practice address

815 W Daughtery Rd
Lakeland, FL 33809-3121

Phone

(863) 859-0475

Fax

(863) 859-0865

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Editha Andrada

Title

Owner

Phone

(863) 859-0475

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LOVING HEART HOME OF LAKELAND Doing business as

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1740449263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W DAUGHTERY RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093121",
            "telephone_number": "863-859-0475",
            "fax_number": "863-859-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W DAUGHTERY RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093121",
            "telephone_number": "863-859-0475",
            "fax_number": "863-859-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRADA GUERZON #1 CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "ANDRADA",
        "authorized_official_first_name": "EDITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-859-0475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687427400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "142291000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOVING HEART HOME OF LAKELAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan E Anderson, ATC
• Olivia Anderson, LCSW
• Skyler Anderson
• Tameka Alnesa Anderson, LPN
• Troy Anderson
• Madison Brianne Andreu
• Arnita Andrews
• Madison Androsko
• Anesthesia Concepts,LLC
• Anesthesiology and Pain Management Consultants,LC

• Assisted Living Facility in Lakeland, FL
• Providers in Lakeland, 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 Jun 9, 2008; 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.