Tina Marie Flannery

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

13002335A Issued in FL

Practice address

5345 Twin Palms Rd
Fruitland Park, FL 34731-6050

Phone

(352) 460-7009

Fax

(352) 504-0233

NPI assigned

Jan 30, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Expectations of Lake County Corporation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fruitland Park, FL
  • NPI 1578413134

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1760332605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W NORTH BLVD STE 2",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483922",
            "telephone_number": "352-460-7009",
            "fax_number": "352-460-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 TWIN PALMS RD",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347316050",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Oakwood Ln",
            "address_purpose": "LOCATION",
            "city": "Fruitland Park",
            "state": "FL",
            "postal_code": "347312330",
            "country_code": "US",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5151 Twin Palms Rd",
            "address_purpose": "LOCATION",
            "city": "Fruitland Park",
            "state": "FL",
            "postal_code": "347314904",
            "country_code": "US",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 W Dade Ave",
            "address_purpose": "LOCATION",
            "city": "Bushnell",
            "state": "FL",
            "postal_code": "335135424",
            "country_code": "US",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SW 66th Pl",
            "address_purpose": "LOCATION",
            "city": "Bushnell",
            "state": "FL",
            "postal_code": "335133588",
            "country_code": "US",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 Newell Hill Rd Fl USA",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347489629",
            "country_code": "US",
            "telephone_number": "352-460-7009",
            "fax_number": "352-504-0233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002472",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002433",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002471",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002375A",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002179A",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "13002335A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Exe
• Rebecah Lynn Farish
• Liza Marie Feliciano, D.M.D.
• Amanda Suzanne Ferragamo, RD
• Fivestar Medical Supplies, LLC
• Florida Hospital Waterman Inc (Adventhealth Fruitland Park ER)
• Alyssa M Forst
• Gentle Sticks on Wheels
• Amy Giddens, OT/L
• Marquisa Denise Gillard

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fruitland Park, FL
• Providers in Fruitland Park, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.