Knollwood Manor Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12576 Issued in FL

Legal business name

KNOLLWOOD MANOR ASSISTED LIVING LLC

Practice address

1203 Windsor Ave
Longwood, FL 32750-6244

Phone

(407) 729-9679

Fax

(407) 951-6698

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Migdalia Mendez

Title

Owner

Phone

(407) 729-9679

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1770029928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 WINDSOR AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506244",
            "telephone_number": "407-729-9679",
            "fax_number": "407-951-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 WINDSOR AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506244",
            "telephone_number": "407-729-9679",
            "fax_number": "407-951-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLWOOD MANOR ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "MIGDALIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-729-9679",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David S Klein, M.D.,FACA,FACPM
• Amalia Jean Klim, PA-C
• Melinda Klinger, MPT
• Holly Beth Kluger, MA-SLP
• Sydney Klyczek
• Barbara Shawn Knowlen, CCC-SLP
• Jenaya Gustavia Knuckles
• Lilly Kolterjohn, R BT
• Lauren Elizabeth Konrardy
• Robert Charles Kramer, DPM

• Assisted Living Facility in Longwood, FL
• Providers in Longwood, 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 12, 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.